Uncategorized Archives - Capital Foot and Ankle
1
archive,category,category-uncategorized,category-1,stockholm-core-1.0.8,ajax_fade,page_not_loaded,,select-child-theme-ver-1.0.0,select-theme-ver-4.2,wpb-js-composer js-comp-ver-6.0.1,vc_responsive
 

Uncategorized

Navicular Stress Fractures

Michael Jordan suffered a navicular fracture

The year is 1985 and Chicago Bull’s Michael Jordan, widely regarded “Greatest of All Time” , sees his foot specialist for foot pain. X-rays were negative and showed no broken bones, but with a CAT scan, which shows X-rays in layers, uncovered a fracture in his navicular bone. This story is revealed in ESPN’s new documentary, The Last Dance.

What is a navicular?

The navicular is a bone in the middle of your foot. Its name is derived from its shape, which has the appearance of a boat. This bone serves a very important role as it allows significant motion and stress forces to pass from the ankle to the foot.

What is a navicular stress fracture?

A navicular stress fracture is a small crack in the bone that has a gradual onset of pain across the top of the foot. These fractures occur due to overuse or ongoing stress on the bone rather than a sudden injury. Due to its pivotal role in transferring forces from the ankle to the foot, the navicular bone is prone to repetitive forces that can cause damage to the bone. Repetitive activities that could result in navicular stress fractures include jumping sports (ie basketball), running, and increased exercise.

How are navicular stress fracture diagnosed?

A history and physical exam are the two most important pieces for diagnoses. X-rays may show a hairline fracture, but may time x-rays will appear normal. CAT scans and MRIs are helpful in confirming the diagnosis if x-rays are negative.

How are these injuries treated?

Your foot and ankle surgeon may recommend non-surgical or surgical options. Typically, the repetitive activity that caused the stress fracture should be stopped for 6-8 weeks. People who perform these repetitive activities due to their job, or are a high-level athlete, or still have pain after non-surgical treatment sometimes do undergo surgery. Surgery allows the patient to recovery more quickly and prevents the return of stress fracture. This treatment involves placement of a screw across the fracture.

When should I be evaluated by my foot and ankle surgeon?

Patients should make an appointment if pain persists after 1-2 weeks with walking or participating activities.

CBD Oil

Many of us have been stuck in traffic and noticed roadside signs or smoke shops advertising for CBD oil. But, does it work? Is it safe? Is it legal? How is it different than marijuana?
Well, we are here to tell you that it is legitimate and it works! CBD (or Cannabinoid) oil is extracted from the marijuana plant. The CBD portion of the plant is extremely valuable, particularly in treating pain. CBD oil is used to unlock the body’s own endocannabinoid system, which effects metabolism, diabetes, pain regulation, inflammation, digestion, and so much more! CBD oil also has none of the hallucinogenic properties typically associated with marijuana or THC.
The benefits of CBD oil are:
– Natural
– Powerful anti-inflammatory
– Fewer/no side effects compared to current medications
– No hallucinogenic properties
In our experience, CBD oils work well for a number of patients including:
– Patients that can not tolerate NSAIDs
– Patients with allergies/dependence issues with opioids
– Patients who have tried numerous options unsuccessfully
– Patients who are not surgical candidates
– Patients with chronic pain
At Capital Foot and Ankle, we carry a wide range of CBD oils. We carry numerous sublingual options and flavors. Most of our sublingual options are full-spectrum, meaning they contain more of the hemp plant than just the CBD, including small amounts of THC (less than 0.3%), however we do carry isolated CBD sublingual oil as well. We also carry gummies and softgels than can be taken orally, as well as several topical options.
If interested, stop in and ask our experts. All of our staff have been trained on the use of CBD oil and are available to answer questions. CBD oils are available over the counter at Capital Foot and Ankle, so no appointment is necessary! Stop in today!

What is a Podiatrist?

What is a podiatrist?

 

This is a question that we get a lot. Sometimes we get confused with pediatricians or pathologists because both specialties begin with “P.” Sometimes, we get confused with pedorthists, because we both deal with feet. Other times we get confused with nail care technicians, because that is where podiatry got its’ start.

Years ago, the practice of podiatry was called chiropody.   At that point, all we were able to do is palliative care like trimming toenails and callouses. Over time, the profession evolved to what it has become today. Looking forward, it is likely that the profession will continue to evolve.

Today, podiatrists have become the experts in everything involving the foot and ankle. Podiatrists are required to first complete undergraduate school. After college, students must apply for and be accepted to one of only 9 podiatric medical schools across the country. The competition for a spot is fierce.

Podiatric medical school is a specialized medical school where students have to decide, prior to starting school, that they will specialize in the foot and ankle. Over the next 4 years, students are taught medicine, often times taking classes with their allopathic peers. However, throughout medical school, systems are taught with a focus on their effects on the foot and ankle.

After medical school, graduates must then complete a 3 year surgical residency. Again, during residency, graduates will rotate through different specialties including anesthesia, orthopedics, emergency medicine, general surgery, and numerous others, all the while still focusing on the treatment of the foot and ankle.

After completing residency, podiatrists will then go through one of the most difficult board certification processes across medicine. Once completed, podiatrists are the experts on the foot and ankle. Podiatrists treat numerous conditions including toe nail issues, diabetic foot ulcers, bunions and hammertoes, arthritis, strains and sprains, plantar fasciitis, broken bones, and so much more.

If you are having trouble with your feet or ankles, come and see our team including the best podiatrists in the area, at Capital Foot and Ankle.

What’s wrong with Cam Newton’s foot?

Cam Newton sees foot specialist for Lisfranc injury

Carolina Panther’s quarterback Cam Newton injured his foot during a Week 2 loss to the Tampa Bay Buccaneers. He has been sidelined due to the injury and hasn’t made progress with this rehabilitation. “I was hiding an injury where I could have easily said, I don’t think I’m ready. Maybe I need to sit this one out…” Newton Said.

What is a Lisfranc injury?

A Lisfranc injury occurs when the bones or ligaments that support the middle part of the foot are broken or torn. The bones and ligaments of the midfoot allow you to walk and transfer your body weight from the heel of the foot to the toes.

How does a Lisfranc injury happen?

A common way to sustain a Lisfranc injury is by directly twisting the midfoot. This type of injury is common in contact sports (ie football). The spectrum of injury severity varies widely from only single-ligament injury to a full fracture-dislocation, which is more severe. Car accidents and crush injuries are other mechanisms that can cause a Lisfranc injury.

How do I know if I have a Lisfranc injury?

Lisfranc injuries are very painful. The pain is most severe to the middle part of the foot. You may not be able to stand on your foot due to the pain. Oftentimes there is significant bruising and swelling that occurs on the top and bottom of the foot.

How are Lisfranc injuries treated?

Treatment of these injuries depends on the severity of injury, mechanism of injury, and patient activity level. Nonsurgical treatment is possible if there are no fractures and the ligaments are not completely torn. The patient may be in a cast or removable boot walker for 6-12 weeks. Surgery is often required when there is a break in the bone or if the joints are out of place. Surgery will put the bones and joints in their proper position and alignment.

How long is recovery?

After surgery, the patient may be non-weightbearing for 6-8 weeks. Weight-bearing is allowed when bones show good healing on X-ray. Regular follow-up visits with your foot and ankle surgeon is critical. Return to sport or activity is entirely possible if proper rehabilitation is followed. Former Nebraska Cornhusker running back Ameer Abdullah sustained this injury several years ago but made a recovery and is now playing for the Minnesota Vikings.

For Cam Newton, return to play this season is unlikely. Even with nonsurgical treatment, the recovery process is extensive. If you suspect you have a Lisfranc injury to your foot, make an appointment with one of our foot and ankle specialists.

Wound Care Myths

“Wounds need air to heal” is probably something that you have heard your parents or even grandparents say. And, it makes sense. Wounds need oxygen to heal and the air is 21% oxygen. This concept dates back to Hippocrates in 400BC! Back then, they didn’t have many options for wound care other than air for wound healing!
However, in the 21st century, we have much better science, research, and options. Drs. Hess and Kirsner did a study in 2003 that actually demonstrates that moist wounds heal 3-5 times faster than dry wounds! Leaving wounds open to air will dry them out and actually slow healing.
Other myths include hydrogen peroxide: effective for first aid, not daily washings as it kills healthy cells, soaking: increases risk of infection and dries out the wound, and covering the wound in the shower: rinsing the wound in the shower lowers bacteria counts and lowers infection risks.
If you develop a wound on your foot, the best treatment is to shower, cover the wound at all other times with a moist dressing such as an antibiotic ointment and a band-aid, and if the wound doesn’t improve rapidly, call and schedule an appointment with us at Capital Foot and Ankle before a small problem turns into a big problem! We have same-day appointments available. Call 402-483-4485 to schedule an appointment.

Ingrown Toenails

Ingrown toenails are a common issue seen in patients both young and old.  They can be painful, and if not treated appropriately, an infection can occur.  Some will very rarely develop an ingrown toenail, while others struggle with chronic ingrown nails.  The good news is that you don’t have to continue struggling with ingrown toenails and there are treatment options available to prevent future ingrown toenails from returning.  We will cover a few causes, signs and symptoms of ingrown toenails, and potential treatment options available.

Potential causes of an ingrown toenail may include trauma to the nail.  This may be something as simple as someone stepping on the toe or could be from stubbing the toe.  The way the toenail is cut can contribute to the development of an ingrown toenail.  You must be careful to not cut back or round the sides of the nail too much because if a piece of nail breaks off there may be a portion that begins to become ingrown.  Occasionally we will see patients who have had a pedicure that may develop an ingrown toenail.  Others are genetically predisposed to developing ingrown toenails based on the curvature and growth of the toenail.

Typically, the first signs and symptoms of an ingrown toenail are discomfort along the nail border accompanied with developing irritation or redness.  Tight fitting shoes may increase the symptoms.  Pressure on the toe from walking, running, or other exercise may be uncomfortable.  Having the toe stepped on often causes increased discomfort.  If the toenail is not properly treated the ingrown toenail may become worse and over time there may be drainage, increased redness and pain, and potentially extra tissue growth may be seen along the nail border.  It is important to seek medical advice early in the process as this makes it less likely you will develop an infection.

You may have read about various treatment options for your ingrown toenails.  The common things people will initially try are digging the toenail out themselves, soaking in warm water or with Epson salt, and an antibiotic may be prescribed if redness develops.  These treatment options are good initial first steps, but often the nail border needs to be addressed to resolve the ingrown toenail.  Fortunately, we have good treatment options for removing ingrown toenails, along with preventing them from returning.  The physicians at Capital Foot and Ankle offer a couple different treatment options to help treat your ingrown nails.  We perform a simple procedure along the nail border to remove the ingrown toenail, which then allows the toe to heal.  If you have not struggled with ingrown toenails in the past, then you may only need a simple border removal.  We typically only need to take a small portion of the nail border which makes the overall appearance of the toenail look relatively normal following the procedure.  If you have struggled with ingrown toenails in the past, then we also offer an effective procedure to prevent the ingrown toenails from returning.  We can remove a small portion of the toenail border and then apply a chemical to the nail cells to prevent regrowth of the border.  This helps to eliminate the portion of the nail which tends to grow and curve into the skin.  This is a simple in office procedure that can be performed at your initial visit which will greatly reduce the likelihood of an ingrown toenail returning.  Most patients who have this procedure performed state that they should have done this much sooner as their toe feels much better and they no longer have to struggle with ingrown toenails in the future.  Again, only a small portion of the nail border is removed, and therefore most people don’t notice a difference in the appearance of their toenail once the toe has healed.  We provide simple care instructions following the procedure, and rarely is much activity restricted.

Capital Foot and Ankle encourages anyone who struggles with ingrown toenails to call and make an appointment to go over your treatment options.  We specialize in caring for your feet and nails and would like to help keep you active and pain free.  Give our specialists a call today if you are tired of struggling with your painful ingrown nails.  We can help eliminate this aggravating problem from returning.

It’s cold outside…..

This has been an exceptionally cold winter here in Nebraska.  We are seeing lots of foot problems associated with the cold weather, including thermal injuries such as frostbite.  Your feet need protection in cold conditions!  Not doing so can lead to long-lasting problems.

It doesn’t take very long – brief exposure to the cold can cause foot problems.   Previous frostbite and cold exposure will certainly make any subsequent cold exposures worse.  People with a history of frostbite are much more susceptible to reinjury.

Cold weather injuries are especially a concern for those in outdoor occupations, outdoor enthusiasts, and people with certain health conditions such as diabetes, Raynaud’s disease, and especially with those that have poor circulation.

Key factors that can increase risks of cold injury

  1. Poor circulation
  2. Previous frostbite
  3. Alcohol
  4. Smoking
  5. Inadequate protective gear
  6. Dehydration
  7. Exposure to moisture
  8. Sweaty feet
  9. Medical conditions
  10. Diabetes
  11. Peripheral neuropathy
  12. Cardiovascular disease
  13. Raynaud’s

Recommendations for protecting your feet

  1. Appropriate shoe gear and socks
  2. Things to look for in shoes

Shoes (or for that matter, socks) that are too tight cause pressure which can decrease blood flow. Shoes that are too loose, or that are made of a mesh, will allow for wind exposure and heat loss.  We recommend being fitted by a professional.  Boots are even better than shoes in the cold weather, especially hunting or hiking boots that come above the ankle.  Look for boots that have insulation like Thinsulate®, and waterproofing such as Gore-Tex®.  You might need to travel to the hunting/hiking/workboot section of your retailer.  ALWAYS fit your cold weather shoes or boots with the accessories you plan to wear (socks, inserts, orthotics).

  1. Things to look for in socks

I like a 2 layer sock regimen for the cold.  The sock against the skin should be a synthetic liner sock made from a material such as polypropylene.  This will allow moisture to be carried away from the skin, and help prevent blisters.  This can be worn under a thicker, full-length sock designed for colder weather, with materials such as Coolmax®, Smartwool®, and Dacron®.

  1. Appropriate clothing

You need to keep warm head to toe.  If the body is cold, the feet will be colder.  Dress in layers, again with a base layer that is synthetic in nature (cotton will hold sweat against the skin), and the outer layer being waterproof.  Modern materials have really changed cold weather gear options!

  1. Change shoes or socks when they become wet

Moisture is the enemy and accelerates heat loss.  This can be avoided with a good waterproof boot.  If you have a condition which your feet are excessively sweaty, your podiatrist may prescribe an antiperspirant.

Charcot Foot

What is Charcot foot?

Like diabetic foot ulcers, Charcot foot is one of the many complications that can arise from nerve damage caused by diabetes. The nerve damage, also called peripheral neuropathy, leads to a loss of sensation in the feet and can throw off one’s sense of balance, which can raise the risk of injury. Such injuries, when occurring repetitively over time, can cause the weight-bearing joints to break down. In severe cases, it can even lead to a total collapse of the foot. With time, the foot may take on an abnormal shape and make walking increasingly difficult.

The condition is often detected well into the late stages, sometimes when damage is so severe that amputation is necessary. This is unfortunate, as detecting Charcot foot early on can allow clinicians to properly treat the bone damage. Casts are generally used to help the bones heal, after which point special orthopedic footwear may be utilized to protect the bones after they’ve healed.  Sometimes, surgical correction is necessary to stabilize the foot.

The biggest problem with Charcot is the lack of awareness.

The American College of Foot and Ankle Surgeons warns that, due to low sensation in the foot, diabetics with neuropathy are less likely to notice sensations of pain or recognize trauma to the feet. They may experience a breakdown of the joints and continue walking on the damaged foot without realizing they have the condition, thereby worsening the situation. As such, people with diabetes need to be more alert to the possibility of damage to the feet and be on the lookout for symptoms of Charcot foot.  The lack of sensation in the feet causes one to be unaware that they may have Charcot foot.

People think they don’t have a problem because they feel no pain, but that isn’t the case. Anyone at risk for neuropathy, including diabetics, alcoholics and some chemotherapy patients, should see a foot and ankle surgeon early and at least once every year, even if they are considered low risk.

 

Symptoms of Charcot foot

Detecting the condition early on is the key to minimizing damage, deformity and the risk of amputation. For that reason, knowing and being on the lookout for signs of Charcot foot is essential. In the first stage of Charcot foot, you may experience swelling, redness and warmth in the feet. X-rays may show swelling in the tissues as well as joint dislocation and bony fragmentation. If untreated, fractures or dislocation may occur, causing severe deformities if the ankle, hindfoot and midfoot arch. In the second stage of the condition, these symptoms may decrease as the damaged bone begins to heal on its own. However, as the foot heals and enters the third stage of Charcot foot, there will be residual deformities that may make it difficult to walk and require extreme medical intervention.

Heightened awareness can help people with diabetes avoid additional complications, such as foot deformity and amputation, caused by Charcot foot.

Anyone who notices a difference – discomfort, unexplained swelling or redness, or changes to the shape of the foot – should seek care right away.

If you are concerned about Charcot, come and see the experts at Capital Foot and Ankle.