Podiatrist in San Leandro, CA
Foot Doctor of the East Bay
1300 Bancroft Ave
San Leandro, CA 94577
(510) 483-3390
(510) 394-6402 fax
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Arthritic Foot Care

In our lifetimes we walk 75,000 miles, putting a great deal of stress on the 26 bones and 30 joints in our feet. As we age, our feet lose flexibility and elasticity. Our shock absorbers weaken, and if you add arthritis to that combination, joints become inflamed and distorted. Arthritic foot care becomes imperative at this point.

Start taking better care of your feet by buying better fitting shoes. Hammertoes, neuroma, and bunions form when our shoes fit poorly. Buy shoes with a lower heel and with more room in the shoe. Rheumatoid arthritis will cause you to lose your arch. Buying shoes with arch support will help, as will buying shoes that contour to your foot.

Leave a fingers width between your foot and the shoe. If your finger cannot fit inside your shoe when it is on your foot, it is too tight. Buy rubber soled shoes. The cushioning of the rubber absorbs shock and the flexibility of the rubber helps the ball of the foot, where you push off from as you walk. Look for square or rounded toed shoes giving your toes lots of room to move.

Exercise will also help. Stretching the Achilles tendon, the cord at the back of the heel, will prevent further pain and injury. This will also increase your foots mobility. Lack of mobility will cause significant stress and pain. Massages will also alleviate some pain. Knead the ball of your foot and your toes from top to bottom.

To stretch your Achilles tendon, lean against a wall, with palms flat on the wall. Place one foot forward and one foot back with the heel flat on the floor, then lean forward. Feel the pull in the Achilles tendon and calf. Hold for five seconds and repeat three times. The big toe stretch is another exercise that may alleviate stiffness. Place one thick rubber band around your big toes. Pull the toes toward the other toes on the foot. Hold for five seconds and repeat ten times. Another exercise to try is the toe pull. Place a thick rubber band around the toes of each foot. Spread your toes for five seconds and repeat ten times.

Pain can be alleviated with non-steroid, anti-inflammatory drugs, heat, and ultrasounds. Topical medications with Capsaicin may also help. Thus far, there is no remedy for pain that is one hundred percent effective. Buying shoes that give your feet plenty room with low rubber heels and soles will help. If needed, use heat and anti-inflammatory drugs, and exercise your tendons and toes. Lastly, arthritic foot care should incorporate massages to help your feet with circulation and to relieve the stress locked up in your feet.



Systemic Diseases of the Foot

There are several systemic diseases, or diseases that affect the whole body, that either display symptoms in the feet or affect the health of the feet. Common systemic diseases that affect the overall health of the feet, and the patient’s ability to walk comfortably, include gout, diabetes mellitus, neurological disorders, and arthritis.

In gout, which is caused by an excessive buildup of uric acid in the body, the most common symptoms of pain, inflammation, and redness occur at the metatarsal/phalangeal joint at the base of the big toe. Any excess levels of uric acid, crystallize and are deposited in tendons, joints, and surrounding bone and muscle tissue. Gout is commonly treated with NSAIDs to relieve pain and inflammation and other drugs to lower uric acid levels in the body. Gout most commonly affects those who are overweight, have low protein diets and lead a more sedentary lifestyle.

Diabetes mellitus is an increase in the level of blood sugar in which the body cannot counteract with naturally occurring insulin in the body. The three types of diabetes, Type I, Type II and Gestational Diabetes, are all signs the body is either not producing enough insulin or is not efficiently using the insulin that is produced. Gestational diabetes only affects women who are pregnant and have never, prior to pregnancy, exhibited symptoms of the disease.

There are two main issues that affect the feet that are commonly caused by diabetes. They include diabetic neuropathy and peripheral vascular disease. Diabetic neuropathy can lead to damaged nerves and affect the feet through numbness and loss of sensation. Peripheral vascular disease restricts the flow of blood to the foot and can, in extreme cases, lead to the necessity of amputating the foot. Peripheral issues that are caused by diabetes and can affect the foot include athlete’s foot, nail infections, corns, blisters, bunions, severe dry skin, plantar warts and ingrown toenails. These can all be attributed to the decrease of blood flow to the foot.

Neurological disorders and rheumatoid arthritis can also have severe impact on the health of the feet. Neurological disorders can affect the nerves in the main structure of the foot and cause loss of sensation and possible decreased muscle response. Rheumatoid arthritis can affect the bones and joint structures of the foot, making it impossible to walk normally without serious pain.

All systemic diseases that affect the foot can effectively be treated to minimize joint and muscle damage if they are diagnosed early and treated with medication and lifestyle therapy. Diabetes patients must monitor their blood sugar levels and work with their physician to keep their levels as close to normal as possible. Rheumatoid arthritis patients should work with their physician to ensure the proper medications are being taken to reduce the amount of damage to the joints of the body.


What Are Ankle/Foot Orthotics?

Orthotics is a medical field concerned with the design, manufacture and use of aids used to support weak limbs or direct the proper function of limbs, in this case the foot and ankle. Ankle-foot orthotics, or AFOs, are braces worn at the ankle that encompass some or all of the foot. Diseases that affect the musculature or weaken the affected area require AFOs to strengthen the muscles or train in the proper direction. Tight muscles that need to be lengthened and loosened also benefit from AFOs.

When we think of diseases that affect the musculature we think of the big boys: muscular dystrophy, cerebral palsy, polio and multiple sclerosis. We rarely think that arthritis and stroke can affect the musculature or that there are some who "toe in". But whatever trauma affects that musculature, there is a way to correct it. The orthosis helps to control range of motion, provide support by stabilizing walk, correct deformities and manage pain load. A podiatrist would be consulted for those who "toe in", for instance, or an arthritis sufferer whose ankles suffer through walking on the job or perhaps a victim of stroke whose musculature is wasting away and requires strength.

Before the advent of modern orthotic devices, it wasn’t uncommon to see polio victims wearing metal braces from mid thigh to the bottom of the foot, or children who "toed in" wearing metal braces around their ankle and foot. However, both designs and materials have improved dramatically, allowing for new levels of comfort, functionality, and appearance. Many orthotics are now made from plastics in the shape of an L and designed to fit inside a corrective shoe. These can be rigid, buckling at the calf and extending the length of the foot to support the ankle. This same design except with a hinged ankle provides support while walking by normalizing the gait. In the past boots lined with leather and fiberboard provided the rigidity needed for correction and support. Now corrective shoes are available with built up soles to correct the gait or manage pain by sharing it with another area when the foot spreads during walking.

The podiatrist would prescribe this orthosis in the rigid L shape because the foot moves on a hinge. If the hinge isn't functioning as intended due to an injury or malformation, the muscles tighten up, thus making it difficult to flex the foot. When we walk, the foot flexes and muscles stretch. This brace or AFO would support the ankle and musculature during flexion of the foot, in much the same way a knee brace works. Corrective shoes are for people whose feet hit the ground backward, causing tight muscles and arch problems. Wedges and rocker bars on the heels correct the step to heel first and rock onto the ball of the foot, resulting in relaxed musculature and strengthened ankles.

Appearance also counts when we consider a particular support device, especially if the item is intended for regular, daily wear. The L shaped orthotic is contoured to the calf and flesh-colored, fitting into a sneaker or dress shoe. As present, corrective shoes are more attractive than past models, enabling patients wear such devices with greater comfort and confidence.



What to Know About a Broken Toe

Although most people try to avoid foot trauma such as banging, stubbing, or dropping heavy objects on their feet, the unfortunate fact is that it is a common occurrence. Given the fact that toes are positioned in front of the feet, they typically sustain the brunt of such trauma. When trauma occurs to a toe, the result can be a painful break (fracture). Another type of trauma that can break a toe is repeated activity that places stress on the toe for prolonged periods of time.

Broken toes can be categorized as either minor or severe fractures. Symptoms of minor toe fractures include throbbing pain, swelling, bruising on the skin and toenail, and the inability to move the toe with ease. Severe toe fractures require medical attention and are indicated when the broken toe appears crooked or disfigured, when there is tingling or numbness in the toe, when the injured person experiences fever or chills throughout their body, and when there is an open, bleeding wound present on the toe.

Generally, a minor toe break will heal without long-term complications, but it is important to discontinue activities that put pressure on the toe. It is best to stay off of the injured toe with the affected foot elevated on pillows. Swelling can be alleviated by placing an ice pack on the broken toe for 15 minutes every two hours during the first two days after the fracture. The broken toe should be immobilized by placing a small cotton ball between the injured toe and the toe beside it, then taping the two toes together with medical tape. 

Severe toe fractures may be treated with a splint, cast, and in some cases, minor surgery; especially when the big toe has been broken. Due to its position and the pressure it endures with daily activity, future complications can occur if the big toe is not properly treated. Pain associated with minor toe fractures can be managed with over-the-counter pain medications, and prescription pain killers may be necessary for severe toe fractures.

The healing time for a broken toe is approximately four to six weeks. In severe cases where the toe becomes infected or requires surgery, healing time can take up to eight weeks or more. While complications associated with a broken toe are immediately apparent, it is important to note that there are rare cases when additional complications, such as osteoarthritis, can develop over time. 

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