Ingrown Toenails: Why They Happen and What Can Be Done?

Ingrown toenails can be extremely painful. They occur when the nail grows into the flesh of the toe. In most instances, it involves the big toe although it can happen on other toes as well. A few common causes for ingrown nails are wearing shoes that essentially crowd the toenail, cutting nails too short or not straight across as recommended, or injury to the toenail. Injury to the toenail is common in some sports and activities such as soccer and dance, where a lot of contact with the toe is made.

Symptoms of an ingrown nail include pain in the toe on one or both sides of the toenail, redness and swelling around the toenail, and infection of skin around the toenail. There are at home treatments available for ingrown nails, but we recommend a visit to our highly qualified podiatrists, particularly if you are experiencing a lot of discomfort in and around your toe or if your toe’s redness or pus seems to be spreading or if you have diabetes or any circulation impairment to your legs and feet. An ingrown toenail can cause a serious bone infection if left untreated, so it is important to address an ingrown toenail when it happens.

There are occasions when an ingrown toenail becomes a chronic problem. When this occurs, the doctor may discuss options with you that could include removing a portion of the toenail along with the nail bed beneath it to prevent the nail from growing back into the skin. Typically the doctor performs this procedure in the office using a chemical.

To help lessen the risk of infection or to treat infection, the doctor may also recommend topical cream or oral antibiotics for ingrown nail treatment.

If you have an ingrown toenail, contact Community Foot Specialists for an appointment at 937-426-9500.

Starting a Fall Walking Program: Choosing a Surface

When getting ready to start walking, it is important to account for the type of surface that you’ll be walking on. Some surfaces are easier on your feet than others. And you may also want to consider whether you’ll be walking on trails where you may face uneven terrain as opposed to a track or the sidewalk where it is more uniform.

Here are a few tips to keep in mind, no matter where your feet take you this Fall:

If you are walking on an indoor track or a newer type of treadmill, then congratulations – you have chosen what is deemed to be the most ideal surface to walk on. These surfaces provide excellent shock absorption and are forgiving to the joins and bones. If you are logging your miles on an indoor track, a good tip is to make sure you change directions periodically to even out pressure on both of your feet.

If you’re drawn to walk on outdoor trails, they are easier on joints and bones than concrete and asphalt. However, their uneven terrain is associated with a higher risk of injury, particularly sprained ankles. It is recommended that you slow your pace so you can navigate the terrain better. And you may want to select trail walking shoes if a lot of trail walking is in your future.

Sand is also easier on joints and bones than concrete and asphalt, but like outdoor trails sand walkers are more susceptible to sprained ankles. It is important to note that you should never run on the beach barefoot – the surface is unstable and may contain sharp shells or debris that could cut your feet.

Asphalt is slightly better than concrete when it comes to your joints and bones, but it is still a very firm surface. If you are walking on asphalt, make sure that you are walking against traffic and that you are wearing bright, reflective clothing. Make certain your shoes have excellent shock absorption.

Concrete is the hardest surface on your joins and bones. It can be up to 10 times harder than asphalt. Limit the amount of time you walk on concrete by alternating walks on indoor tracks or other surfaces.


Starting a Fall Walking Program: Are Orthotics Right for You?

If you currently have pain in your arch or bottom of the foot or you’re planning on more than the occasional leisurely walk this fall, you may want to consider whether a pair of orthotics may be the right fit for you. There are a number of different orthotics, or inserts, on the market at all different price points.

There are drugstore orthotics – brands like Dr. Scholls or generic store brands you can pick up from a grocery store, CVS, Walgreens, Rite-Aid, Meijer, or Wal-Mart. These can cost anywhere between $10 and $50 for a pair. The pros for these orthotics mainly are the cost. The cons are that you get what you pay for – and you won’t be able to get a custom fit from these orthotics since you buy them right off the shelf.

There are heat-molded orthotics that we offer in our clinics, which can be made instantly for the patient in the office while they wait. These orthotics are called JM orthotics, and cost $80 per pair. Most insurance plans do not cover the cost of these orthotics, so make sure you talk with your doctor about your options. The pros to these orthotics are that they are quick and easy to make for the patient, as well as easy to adjust if the patient has a problem with them. The cons are that they are not covered by most insurances, so they have a higher out of pocket cost to the patient.

Custom orthotics are created by making a mold of your foot and casting it. These casts are then sent out to an outside company to create a custom orthotic. These can cost nearly $300 a pair and are covered under some insurances. The pros to these orthotics are that they are probably the most closely molded to your foot. The cons are that they take a long time to create and get to the patient, and they are difficult to correct if the fit is wrong.

Orthotics can be used to correct foot abnormalities when standing, walking, or running. They don’t just provide the foot with arch support – they alter the angle at which the foot strikes the ground, helping to improve the way your feet function and feel.

Starting a Fall Walking Program: Selecting the Right Shoes

With the dog days of summer drawing to a close, many people are coming out from their air conditioning hibernation and hitting the streets of their neighborhoods to enjoy the fresh air and log some miles on their walking shoes. While it is true that anytime you move from a period of relative inactivity to a more active lifestyle, you run the risk for injury, we’ve got a few tips to help lessen your risk. Today we’ll focus on shoe selection.

Did you know that a 150 lb person who walks just one mile exerts a force of 63.5 TONS on EACH ONE of their feet? This startling statistic, courtesy of the American Podiatric Medical Association, illustrates the beating that our feet take on a daily basis. To help protect the foot, it is important to make sure you have good walking shoes that are well suited to your foot type (low, medium, or high-arch) that fit into one of three functional categories (motion control, stability, neutral).

For those with low-arches, flat and generally straight feet, you want to select a motion control shoe. This would be a shoe that is straight shaped and the most rigid and resistant to twisting and bending.

Those with medium-arched feet, which are typically referred to as ‘normal’, should wear shoes that fall into the stability category of function, which have a slightly curved shape.

People with high-arched feet should seek a shoe from the neutral category. These would be shoes that are curved and the least rigid and resistant to twisting and bending.

Study: More Americans Having Bouts with Gout

A new study published in the journal Arthritis & Rheumatism reveals that 8.3 million Americans suffer from the incapacitating condition of gout – up from 6.1 million Americans 20 years ago.

Gout is caused by high uric acid levels in the bloodstream, causing crystals that precipitate in joints of the foot. Gout pain typically affects the joint of the big toe. (This is true in just about 75% of cases.) As uric acid levels increase, so does the likelihood of gout pain. Gout pain typically manifests in episodes – called gout attacks or gout flares. During a gout attack or gout flare, a person feels an extreme amount of pain and experiences severe swelling and redness in the big toe. A gout attack or gout flare can last just hours or days, but over time they can last longer, occur with greater frequency, or even become more painful.

These attacks or flares may occur only at certain times of the year. Typically they start during the night without warning. Patients sometimes complain that it hurts to even have a sheet touch the inflamed area when lying in bed. A number of triggers have been identified which are responsible for gout attacks. They include alcohol, dehydration, certain medications, stress, certain diets that are high in purines from meat and fish, and rapid lowering of uric acid levels with medication.

Treatment of gout is usually done with anti-inflammatory medication and steroids. Lifestyle changes – such as the avoidance of alcohol, diet low in purines from meat and fish, and even exercise – can be helpful in lessening the likelihood that you will suffer from gout attacks.

Beetle Juice to Treat Your Feet? Cantharone Treatment for Warts Available

No – the beetle juice we reference here is not the creepy character in the 80s movie of the same name. It is a part of a popular treatment available in our office to take care of plantar warts.

The benefits to the Cantharone treatment – also known simply as beetle juice – is that there is no at-home application needed. It is the quickest and most effective wart removal treatment available.

Your podiatrist will put a small amount of Cantharone on the affected area and place a patch over top of it. Cantharone is a blistering agent that will separate the affected layer of skin from the healthy layers, allowing the affected skin to be removed and the healthy skin to be revealed. Typically, it will require between one and three applications of the agent to remove the blister, which means regular office visits for anywhere from 1-4 weeks. It will require you to keep it dry for 24-48 hours after each application, so you may want to be sure to shower before your visit since you won’t be able to get the area wet for another day or two afterwards!

While Cantharone doesn’t hurt for the majority of patients, it does occasionally cause a relatively severe pain sometime between 2 to 12 hours after application that could potentially last several days. There is no way to know for sure whether you will experience pain after the application, but the doctor can prescribe pain medication for you should you be one of the unlucky ones. Call your doctor if it becomes painful and he or she may be able to recommend another course of treatment.


Diabetes Rates Double Worldwide

Since 1980, the worldwide rates of diabetes have nearly doubled, according to a recent report published in the British journal Lancet. Throughout the world, more than 347 million people are diabetic, with 25 million of those people right here in the U.S.

Previous estimates reported in 2009 were 25% less than the current study. This is partially due to the fact that the new study has a more comprehensive calculation of the prevalence on a worldwide scale.

The U.S. currently has one of the fastest growing diabetes rates, which is in stark contrast to 1980 where it had one of the lowest. Rates for men have increased more rapidly than those for women, although both have increased by over 4 percent since 1980.

The cause of the worldwide rise in diabetes is not clear. Previous assumptions centered on the idea that increased economic success has lead to a more sedentary lifestyle and a diet with higher levels of refined carbohydrates. However, this does not hold true with the latest data – China, for example, has had recent economic improvements that have not resulted in a diabetes increase. Also, India had the sixth largest rise in diabetes rates but the lowest increase in average body mass index, which is a leading indicator for diabetes.

So what does this mean for podiatry? Well, with more cases of diabetes in the world, it also means more people in need of diabetic foot exams to make sure that there are no current problems with their feet or no indicators of potential problems in the future.

If you have diabetes and have not had a foot exam within the past year, contact Community Foot Specialists to schedule an appointment today.


The Importance of Consistent Diabetic Foot Care

by Belinda M. Dotter, DPM

Diabetes runs in my family. Maybe that is why I have taken a particular interest in diabetic foot care, because for me it is personal. If you are diabetic and reading this article, kudos to you for looking into making foot care a part of your diabetes management plan. Please keep reading though – there is much you can do to help yourself and others with diabetic foot care. Anyone with diabetes, regardless of whether they are experiencing any foot problems at the time, should receive an annual foot exam to help identify any potential changes in the condition of their foot. But they should be looking at their feet – or asking a caregiver or loved one to look at their feet – on a daily basis to be alerted to any injury or change in condition that would require a call or visit to the podiatrist. Remember that with diabetes comes a possible decrease in circulation in your feet and possible nerve damage, resulting in a loss of sensation in the feet. This sensation would normally serve as the body’s warning if an injury or ulcer were to develop. If you know someone who is diabetic that has not had a foot exam in the last year, please encourage him or her to call our office and schedule an appointment. Share with them the knowledge that annual foot exams should be an integral part of their diabetes management plan, and that their podiatrist should be a valuable member of their health care team. Thank you for trusting your foot and ankle care to Community Foot Specialists.

Active Summer Foot Care

At this time of year, you may find yourself outside more often. Maybe you’re looking forward to a vacation – feeling sand between your toes at the beach, taking a hike in the mountains, lounging by the pool. Perhaps you’re thinking about taking the kids or grandkids to Kings Island or the Columbus Zoo. Or maybe you’re spending a little more time doing yard work or tending to your garden.

Feeling the sand between your toes at the beach can be great, but getting a piece of glass or a shell stuck in your foot is not. That’s why Regardless of your outdoor activity, you want to be sure you’re taking care of your feet while taking part – so an otherwise pleasurable experience won’t be the cause of future foot pain.

When at the beach or the pool, you want to be sure to have shoes with you. At the beach this is important because shells and other items can be sharp and puncture your foot, which could lead to infection. At the pool, wearing flip flops around the pool deck and in the locker room areas is critical to protecting yourself against sharp objects, plantar warts and athlete’s foot.

When hiking or doing a lot of walking, you want to make sure you are wearing comfortable shoes that provide adequate support. Your choice of socks is also important. Wear socks that help wick away moisture to help reduce the chance of blisters. You may also want to change your socks midway through the day.

And when working in the yard or gardening, make sure you are also wearing appropriate footwear. Don’t wear flip flops or open toed shoes when mowing the lawn, as rocks or sticks kicked up by the lawnmower could cut your feet and cause significant injury.

Wearing the right footwear is key to enjoying yourself this summer. Make it a great one!


Dismissing Diabetes Diet Myths: #1 – Eating Too Much Sugar Causes Diabetes

It is no secret that living with diabetes means you may have to change your eating habits and possibly cut back on certain foods to manage the condition. But there are a number of ‘diabetes diet’ myths out there that simply aren’t true. Let’s lay one to rest today.

#1: Eating Too Much Sugar Causes Diabetes – The amount of sugar you consume is unlikely to cause diabetes on its own. Diabetes occurs when your body’s ability to turn food into energy is disrupted. The body is supposed to break down the food you eat into glucose, which is a type of sugar needed to power the cells of the body. The pancreas makes a hormone called insulin, which helps cells utilize glucose for fuel. In Type 1 Diabetes, the pancreas does not make insulin. This usually occurs in children or young people, and is thought to occur as a result of something happening with the immune system. In Type 2 Diabetes, the pancreas either does not make enough insulin or the insulin does not work properly. In some instances it is both. Type 2 Diabetes can occur in people of any age, although being overweight increases risk. Gestational diabetes can occur during pregnancy for some women when hormone changes prevent insulin from working properly. While the condition may resolve after the birth of the child, those with gestational diabetes usually need to take insulin.

Essentially, it is important to note that it is not the amount of sugar that’s to blame – it is the body’s ability to metabolize that sugar properly and turn it into energy that is the problem. So while eating sugar won’t cause diabetes, when you are at risk for diabetes or when you have diabetes, it is important to limit your sugar intake somewhat.