Hitting the Field? Here’s How to Avoid Athlete’s Foot

Athlete’s foot affects about one in five people, according to certain studies cited by WebMD. Luckily, it’s a very treatable condition, but that doesn’t mean it’s pleasant to endure. In fact, it can be quite detrimental to a person’s performance both on and off the sports field.

Though technically a fungal infection (known medically as tinea pedis, “ringworm of the foot”), athlete’s foot can at first just appear as incredibly dry skin, though if left unchecked, it could leave to a number of more severe foot problems, like burning pain and oozing blisters. So, what causes this unfortunate condition in the first place?

• Tight shoes: Any piece of footwear that squeezes toes together can help cause athlete’s foot, and plastic shoes tend to be the worst offenders, because of how they trap moisture near your feet.
• Sweating: Really, any lingering moisture inside your socks or shoes will up your risk of developing athlete’s foot symptoms.
• Direct contact: Though you’re probably not often touching your teammates’ feet, the infection can be spread in locker rooms through either accidental contact or…
• Indirect contact: A surface that’s been infected in a locker room (like a sock, a towel or even a bathmat) can also transmit the fungus to you.

If you’ve ever endured athlete’s foot, you understand how uncomfortable and painful it can be. As we mentioned above, the symptoms aren’t permanent, but they can still be a nuisance to deal with. In order to avoid this kind of foot pain whether you’re trying out for varsity or simply tossing the pigskin in the backyard, here’s what should you do:

Keep your feet dry.
After the game, it’s important to let your feet air out. Keeping moisture trapped between your toes is one of the ways athlete’s foot can get started in the first place, so try to avoid keeping your toes cooped up for too long. Along those same lines, changing your socks often (even in the middle of a game) can do wonders for general cleanliness.

Wear ventilated shoes.
Because athlete’s foot causes foot pain, it’s important to invest in shoes that feel as comfortable as possible. But even above comfort, ventilation should be your number-one priority when it comes to footwear. More airflow means less moisture for your feet, and that’s good news for trying to ward off infections and harmful fungi.

Protect yourself.
It’s not just the sports field you have to worry about — it’s the locker room, too. Invest in a good pair of sandals or shower shoes to wear when you’re rinsing off after the game, and do the same thing at public pools and fitness centers. Plus, it’s a good idea to pick up some powder (anti-fungal is best) to apply after every shower, to treat your skin.

For more information on lingering foot pain, athlete’s foot treatment and general infection prevention, find a podiatrist near you who can answer your questions.

Ask The Dr Ankle Sprain

“I didn’t see the pot hole when running on some back roads recently and I think I twisted my ankle, what should I do”?

The most common ways to sprain an ankle are by landing awkwardly after jumping or by walking/running on uneven surfaces.

A sprain occurs when your ankle is forced more out of alignment than normal. This can cause a stretch or a tear to the ligaments which hold your ankle in alignment and which give your ankle a feeling of stability.

• Stop your run if pain has occurred. Stand up slowly to be sure pain doesn’t sit you back down. If it does, do not restart running.

• Apply ice to the ankle 15 minutes an hour for the remainder of the day.

• Perform “ABC” range of motion exercises three times a day. These are done by leaving your hip, knee and leg still, move your foot as though you are writing out the alphabet in large capital letters, If this causes soreness, continue exercises. If this causes pain, seek medical attention.

 Seek medical attention for your sprain if;

• Pain keeps you from putting any pressure on your foot that day

• Pain continues for more than three days

• Your ankle feels weak or gives out on you while walking/running

• Your feel or hear a “pop” at the time of injury. A “pop” usually means you tore a ligament, tendon, muscle or broke a bone.

 If you don’t properly treat an ankle sprain:

• You are more likely to sprain it over and over causing more and more damage.

• You may have chronic pain, weakness, instability or inability to resume running

Ask the Dr Neuroma

“My feet burn and go numb when I am running, should I be concerned”?

That depends on how long the burning or numbness lasts. If your feet burn or go numb while running but then that feeling goes away within 5-10 minutes at the end of your run, then this likely indicates that your shoes aren’t fitting your feet well.

• With repetitive motions such as running, using the elliptical machine or stair climber your shoe stops when it hits the surface, but if your foot slides forward too much inside the shoe then this can cause the nerves (on the bottom of the foot) to become agitated and feel a numb/burning sensation.

• This will usually affect the entire bottom of both feet.

• Trying a different style of shoe or lacing your shoes more securely should help.

If the numbness occurs in one foot and is more localized to the ball of the foot then you may have a neuroma.

•  A neuroma is the thickening or inflammation of a nerve on the ball of the foot, leading to your toes

• You may feel as though you are stepping on a pebble or as though there is a wrinkle in your sock.

• Frequently you will feel an electric shock or numbness into your 3^rd and 4^th toes or your 2^nd and 3^rd toes. (think “I hit my funny bone” feeling).

Self care would include a wider toe box on your shoes or more cushioning at the front of your shoe.

Seek medical attention if symptoms persist for more than 30 minutes after your run or don’t resolve with altered shoes. The longer you run with a painful neuroma, the more aggressive professional treatment may need to be. It’s easier to treat early.

Your Feet Need Blood to be Healthy

P.A.D or atherosclerosis:

• Is a narrowing or occlusion of the arteries
• This occurs in the legs, and it can affect the feet.

Symptoms of PAD:

•  The most common symptom is claudication.

Claudication can feel like a dull cramp, fatigue or pain in your hip, thigh or calf muscles when walking, moving, or exercising and the cramps or pain goes away upon stopping activity. If this pain occurs each time you walk the same distance, the likelihood of the diagnosis increases.

• Rest pain or pain in the feet occurs when sleeping or with legs elevated, yet is relieved by dropping legs lower than your hips is another common symptom of PAD.

• PAD occurs frequently in diabetics. If you have nerve damage or neuropathy, your symptoms of PAD may be masked. PAD can lead to acute limb ischemia or gangrene.

PAD can lead to acute limb ischemia or gangrene. It is characterized by a lack of pulses in the feet, pain in the toes especially at rest, paleness to the foot especially with the leg above the heart, coldness or one foot cooler than the other foot, tingling or numbness in the foot, and paralysis. Your feet might feel better if your legs are lower than your heart because gravity may assist in the blood flow to the feet. So, if you find yourself sleeping sitting up because your feet feel better that way, you may be suffering from inadequate blood flow to your feet. Having PAD can increase your risk of heart attack and stroke. Early detection and treatment are essential.

Your Podiatrist can screen your feet for PAD. If you think you have PAD, stop smoking and or using tobacco immediately, control your glucose if you have diabetes, control your blood pressure and start an exercise program after consulting with your physician.

Proper foot care if you have PAD:

•  Wear appropriate footwear
•  Do a daily foot inspection
• Use a moisturizer daily
• Any skin lesions or ulcers should be addressed immediately
• See your Podiatrist for preventive education, evaluation and treatment.

Can Running Through the Pain Cause Permanent Nerve Damage?

One of the most difficult things for a runner to determine is when it is okay to keep running through pain versus when it’s time to ease up. It is a very common thing for runners to experience various aches and pains due to general muscle soreness, so not every pain you feel will be a significant cause for concern. There are, however, times when it may be necessary to pay attention to what your body is telling you in order to avoid any long-term, or possibly even permanent, injuries.

Pain is quite a complex phenomenon, and it comes in many different forms, making it difficult at times to nail down what may be the cause of what your body is feeling. It is important to note that pain does not always equal muscle, tissue or nerve damage; for example, cramps can be very painful, but only in very rare cases can they cause permanent damage to your muscles. So if pain can be somewhat misleading, is it okay to just say “No pain, no gain” and keep running when you’re feeling significant pain? If you do decide to run through the pain, does that put you at risk of experiencing permanent nerve damage?

The answer will depend upon where exactly you’re experiencing the pain, as well as how severe the pain is. If you run frequently and are experiencing mysterious pain running through your foot, you may be dealing with a nerve issue. When a nerve is irritated or injured, it can produce symptoms such as weakness, burning sensations, loss of motor function, numbness, tingling, or shooting pain through your foot. If you’re experiencing any of these types of symptoms, it is not advisable to continue running, as this may aggravate the injury and possibly cause more permanent damage.

Sometimes muscle inflammation due to overuse can be the cause of nerve problems; the inflamed muscle may begin to put extra pressure on the nerves in your foot, essentially trapping or pinching those nerves. This type of condition can affect several different regions of the foot, and is often treated by cortisone (anti-inflammatory) injections. Another condition known as neuroma affects the nerve between the toes. Neuroma makes it very difficult to put weight on the ball of the foot, and often may feel swollen, like there’s a rock in your shoe. Excessive and repetitive high-impact exercises (i.e., running) can create or further aggravate neuroma; cortisone injections are used to treat this condition as well. It’s always best to treatment with non-addictive protocols, especially if you have a history of substance abuse treatment.

A good rule of thumb to use is that if something hurts so bad that it’s difficult for you to walk on it, you should not be running on it. Although it may be tempting to just write off the pain and power through, it is always better to be safe than sorry when it comes to your health. In addition, it is a good idea to visit a podiatrist to properly diagnose the issue. If you still want to remain active during your break from running, you can engage in low-impact exercises such as swimming, rowing or biking, in order to reduce symptoms of nerve damage without risking further injury.

Foot Care Tips By Dr. Titko …Revealed!

The following article is based on Dr. Titko’s long-standing expertise with helping with the relief and prevention of a wide range of painful foot and ankle problems.

 PROPER SHOES TO PROTECT YOUR FEET IF YOU HAVE DIABETES

The number one reason a person with diabetes is admitted to the hospital is for foot ulcers or openings in the skin.

• 70% of these ulcers result in amputation.
• A corn or a callus (hard skin on top of your toes or on the ball of your feet) indicates a pressure point and in people with diabetes, this means an area at greater risk of ulceration or infection.
• Prevention is the key to avoiding amputation.
• By wearing properly fitted shoes, before an ulcer starts, the risk of amputation is reduced. In addition to fitting properly, the shoes must have solid support with protective custom inserts.
• If your feet have nerve damage (neuropathy) from diabetes, you may be unaware of ill-fitting shoes. Shoes that are too tight or too small can lead to ulcers.
• Fortunately, most insurance plans cover custom fitted shoes and inserts for those feet at risk of damage as a result of diabetes. These shoes are available by prescription only from your podiatrist.
• Don’t wait until it is too late to be sure that your shoes will help keep your feet healthier, longer.

THE BOTHER WITH BUNIONS

 A bunion is a bump just behind your great toe and is hereditary in nature.

• Pain from a bunion is different for everyone; size is not an indicator of pain.  Bunions can be painful whether they are small or large and some are not painful at all.
• If there is pain from the bunion, it is usually noticed after, rather than during, activity.
• Bunions occur in women more frequently than in men.
• Shoe pressure against the bump or arthritis in the great toe joint can be a source of pain. Bunions may be more painful in tight fitting shoes.
• Ice, wider shoes, and over-the-counter medications may be helpful to reduce the pain in the early stages.
• Because bunions form as a result of a mechanical defect in the foot structure, orthotics (custom prescribed inserts for your shoes) may help to alleviate the pain.
• Although surgery is sometimes necessary, your podiatrist can offer other treatment options that may help you avoid or delay surgery for this joint pain.

 WHEN A SPRAIN IS NOT A SPRAIN

If you have ever turned your ankle or felt like your “ankle gave out on you”, you may have suffered one of the most under treated injury of the body – an ankle sprain.

• If it hurts bad enough you may go to the emergency room or have x-rays taken at your doctor’s office. Even if the x-rays show no broken bones, there could be damage to the ankle that can’t be seen on the x-rays.
• If x-rays say nothing is broken, try starting with exercises for your ankle: pretend your foot is a pencil and draw out the alphabet three times a day.
• You may feel it’s not bad enough to initially seek medical attention and decide to “just walk it off.” But if there is bruising or if the pain or swelling persists, then your ankle requires more investigation.
• Ligaments help your ankle to feel stable and secure. Tendons give your ankle strength. When bones don’t break, frequently ligaments or tendons tear. If left undiagnosed or untreated, a “simple sprain” can lead to long term weakness, instability and pain.
• Because ligaments and tendons can’t be seen on an x-ray, an ultrasound or MRI will help diagnose tendon or ligament tears. Your podiatrist can help your ankle become less swollen, less painful and regain its strength and stability.

 WARTS ARE CONTAGIOUS

• Once you have had a wart on your foot, there is a 20% chance you are going to get another one.
• If you have warts on your feet you can easily share them with your friends and family.
• Frequently, but not always, warts on your feet can look like raised areas with dark dots (that look like seeds but they are not) or flat and whitish-yellow in color. Usually there is pain when standing if they are on your heel or the ball of your foot.
• You may start with one, but more may be coming soon. They tend to spread to other feet through wet surfaces such as the shower floor, bathroom tile or rug.
• Use caution when trying to treat these areas with medications bought at the store. Many of these treatments involve using acid on your feet and may cause chemical burns.
• Recognize that not all lesions on your feet are warts; they may be calluses, clogged sweat glands (like a pimple you may get on your face but very painful) or a host of other skin conditions including melanoma (skin cancer).
• Professional diagnosis and treatment by a podiatrist are recommended for their enhanced safety and effectiveness.

 DO YOU HAVE HEEL PAIN THE FIRST FEW STEPS IN THE MORNING?

The most common cause of heel pain is known as Plantar Fasciitis. It may be caused from over strain or under support of your feet, trauma or poor mechanics.

• A podiatrist can do a complete exam to check for other causes of heel pain including: stress fracture, damaged nerves, tumor and many others.
• Plantar fasciitis is easier to treat with faster results if diagnosed early. Some at home remedies for heel pain; take over-the-counter anti-inflammatory medicine, apply ice to your heel 15 min of every hour, roll your arch over a baseball or can of soup and wear good supportive, comfortable shoes.
• If your heel pain persists you many need x-rays to rule out other causes of heel pain such as a fracture, tumor, or foreign body. Ultrasound or MRI can help rule out tendonitis or arthritis.
• Your podiatrist can help to control any mechanical defect of your feet with the use of orthotics or physical therapy, and the recommendation of the proper shoes to wear. You may need your feet strapped/taped for enhanced support. The use of other medications can help relieve your heel pain.
• There are some exciting new treatments for heel pain that are minimally invasive and may give long lasting relief.
• The key to quick and long-lasting comfort is an early diagnosis and immediate start of treatment.

SUMMER SPORTS CAN BE HARD ON YOUR FEET

• If you were less active in the cooler months and waited for the sun to come out to increase your activities – your feet may not be ready. Without properly preparing your feet for increased exercise, you may develop heel pain, muscle strains or tendonitis in your ankles.
• Your shoes should match your sport. For example; do not run long distances in basketball shoes. You should always wear firm soled athlete shoes for all sports or activities, not flimsy, non-supportive shoes. If you do develop heel or ankle pain you may need custom-made orthotics – these offer superior support to any over-the-counter shoe insert.
• Proper stretching of your tendons may help to prevent foot and ankle pain during sports or activities. Consider rolling your arch over a can of soup or a frozen bottle of water and with your knee extended pull your toes up toward your nose to stretch your Achilles before and after sports or fitness activity.
• If you have foot or ankle pain that occurs either during or after your fitness activity, see your podiatrist for a complete exam, proper diagnosis and treatment options to alleviate these pains and to prevent future injuries or pain.

INGROWN TOENAILS – PROPER CARE GETS YOU BACK ON YOUR FEET

• Ingrown toenails can cause pain and become infected.  If the skin around you nail is red or if pus is seen around the nail, some self-treatments may make the condition worse.
• Try soaking your toe in luke-warm water with a little Epsom salts or liquid dishwashing detergent. Apply an antibiotic ointment and band aid to the nail area. If no improvement is seen in 2-3 days, you may require professional treatment.
• Ingrown toenails are usually hereditary in nature, but sometimes trauma can be the cause. Be sure to check your children’s nails, especially if you have suffered from this condition.
• Try wearing wider shoes to prevent the pressure on your toe which would increase you pain.
• Antibiotics may temporarily offer relief.
• If pain, redness or pus continues, seek professional intervention from a podiatrist for lasting comfort.

For the last 17 years, Dr. Titko has been leading the charge for good foot health through her practice at the Center for Foot Care. Together with her staff, she has developed the Center for Foot Care into a practice that provides superior quality medical and surgical care of the foot and ankle to the local and extended communities of Cincinnati. You can reach Dr. Titko at either of her office locations, in Mt. Healthy on Hamilton Avenue at 513-729-4455 or in Erlanger on Dixie Highway at 859-341-0575. For more information, visit www.CincinnatiFootCare.com

Proper Shoes For Diabetics

Kristin K. Titko, DPM, MBA, is a board-certified specialist at the Center for Foot Care, a leading podiatric practice in Cincinnati. Dr. Titko has written several articles on achieving and maintaining good foot health, and regularly presents seminars and lectures on podiatric health to various local groups, including diabetic focus groups, the arthritis foundation, and school-age children and their parents.

The following article is based on Dr. Titko’s long-standing expertise with helping with the relief and prevention of a wide range of painful foot and ankle problems.

PROPER SHOES TO PROTECT YOUR FEET IF YOU HAVE DIABETES

• The number one reason a person with diabetes is admitted to the hospital is for foot ulcers or openings in the skin.
• 70% of these ulcers result in amputation.
• A corn or a callus (hard skin on top of your toes or on the ball of your feet) indicates a pressure point and in people with diabetes, this means an area at greater risk of ulceration or infection.
• Prevention is the key to avoiding amputation.
• By wearing properly fitted shoes, before an ulcer starts, the risk of amputation is reduced. In addition to fitting properly, the shoes must have solid support with protective custom inserts.
• If your feet have nerve damage (neuropathy) from diabetes, you may be unaware of ill-fitting shoes. Shoes that are too tight or too small can lead to ulcers.
• Fortunately, most insurance plans cover custom fitted shoes and inserts for those feet at risk of damage as a result of diabetes. These shoes are available by prescription only from your podiatrist.
• Don’t wait until it is too late to be sure that your shoes will help keep your feet healthier, longer.

For the last 17 years, Dr. Titko has been leading the charge for good foot health through her practice at the Center for Foot Care. Together with her staff, she has developed the Center for Foot Care into a practice that provides superior quality medical and surgical care of the foot and ankle to the local and extended communities of Cincinnati. You can reach Dr. Titko in Mt. Healthy on Hamilton Avenue at 513-729-4455. For more information, visit www.CincinnatiFootCare.com