Flatfoot Deformity
Being “flatfooted” is much more complex than it sounds. There are a wide array of symptoms and deformities associated with being flatfooted. Since there are so many contributing factors to low arch height, a proper evaluation is warranted. A flatfoot can be rigid or flexible, however, in this discussion, we will discuss only flexible flatfoot, since it seems to be the most common presentation.
Flexible flatfoot usually begins in childhood and progresses through adulthood. It often occurs in both feet and worsens with age. As the deformity progresses with age, the tendons and ligaments that hold up the arch with stretch and tear and become inflamed.
A flexible flatfoot means that your arch flat only with standing, but the arch returns with sitting.
Diagnosis of a flatfoot is made with clinical evaluation by Dr. Kory Williams or Dr. Eric Silvers. X-rays are normally ordered to see the bones and joints.
Conservative Treatment
1. Shoe modifications – wear supportive athletic shoes and avoid flip-flops and other shoes that have no arch support.
2. Activity Modifications – avoid situations in which you stand or walk for a prolonged time. Give your arches a rest.
3. Weight loss – if you are obese, try to lose some weight. Too much weight can aggravate your symptoms.
4. Orthotics – Custom orthotic devices (that go into your shoes) are the best conservative treatment available.
5. Immobilization – sometimes a walking cast or going keeping weight off the limb is the best option.
6. Medications – Anti-inflammatories
7. Physical Therapy – this can provide temporary relief.
When conservative therapy has been exhausted and every non-surgical attempt has been tried, then surgery can be performed.
Traditionally, flatfoot surgery is not performed in kids less than 12-13 years old. The type of flatfoot surgery varies from patient to patient. The type of flatfoot surgery depends on:
1. The amount of deformity present
2. The type of deformity present
3. Other health problems
4. Patient’s ability to responsible after the surgery
Dr. Kory Williams and Dr. Silvers are well versed and trained in the area of flatfoot surgery. If you or your child has a flatfoot deformity, please make an appointment at Advanced Foot & Ankle Center in McKinney, TX and Prosper, TX. Call 972-542-2155.
Can Metformin Give you Nerve Pain?
Metformin has long been a mainstay in the world of diabetic oral medications to lower blood glucose for the last 50 years.
However, recent studies have been shown that Metformin can actually lower the levels of Vitamin B12 in the body and in turn, cause nerve pain or neuropathy.
The nerve pain symptoms can include:
1. Numbness and tingling in the fingers and toes
2. A poor sense of balance
3. Depression
4. Dementia
Obviously, as podiatrists, we are most concerned about the manifestation in the legs and feet.
These symptoms can be controlled and the low Vitamin B12 can be reversed with help from a medicine called Metanx.
Metanx is a prescription medical food for the dietary management nerve symptoms.
You may read more information at the following website:
If you have take Metformin and are having nerve sympt0ms, please come see Dr. Kory Williams or Dr. Eric Silvers at Advanced Foot & Ankle Center in McKinney, TX and Prosper, TX for treatment.
Thank you,
~Dr. Williams
Are Flips Flops Bad?
Finally, the days of summer are upon us. At last we can kick off our shoes and winter boots and slide into some sandals or flip flops.
A podiatrist in Louisiana studies the effects of flip flops in 100 people. He found that by using the toes to grip and keep the flip flop in place, people work the muscles in their shins much more than when they are barefoot. He said that short walking strides while wearing flip flops can also strain the lower legs. He felt that flip-flops with deepened heel cups and defined arches can remove some of the stress from the legs and feet, but a sneaker is preferred when performing extensive walking or activities.
Another podiatrist felt flip-flops do not provide shock absorbing qualities. She also felt that flip-flops shorten the stride, making muscles work harder in the legs and feet which ultimately leads to compensation by the knees, hips and back. This compensation could lead to injuries. She recommends finding a sandal with a back strap and deep heel cups.
How to Avoid a Flip-Flop Fiasco
The APMA has a complete list of flip-flops given the “Seal of Acceptance”.
Click below for the list:
List of Flip-Flops Approved by the American Podiatric Medical Association
Is Barefoot Running Good For Your Feet?
Now days, more and more shoegear is being developed to simulate barefoot running. Is this good for your feet? Is this bad for you feet?
Running barefoot has shown to caused runner to have a shorter stride length and ultimately lower the impact forces during running. Wearing “Vibram” or “Five Fingers” shoes have shown to simulate barefoot running, but provide a small amount of protection.
Studies have shown that some running shoes restrict the natural motion of the foot, therefore causing the foot to perform a specific foot motion pattern designed for the shoe and not the person’s running style.
It has been thought that the tiny muscles in the feet are used more effectively when running barefoot, therefore improving foot function and increasing foot efficiency during running.
It has also been thought that as the heel strikes the ground while running barefoot, causes less of an impact and shock absorption. This allows the runners center of gravity to cause more stable running alignment.
The increased risk of running barefoot is lack of cushioning. This may subject the patient to increased skin problems such as calluses, and impact injuries such as stress fractures. It is also thought that the plantar fascia will become more strained and lead to increased risk of plantar fasciitis. Also, achilles tendon injuries are thought to increase with barefoot running.
It is felt that most runners have not been taught proper running form and therefore, this coupled without proper shoegear will lead to injuries.
So it running barefoot a good or bad idea? You be the judge.
~Dr. Williams
Do You Have Poor Blood Flow?
When the legs and feet have poor blood circulation, the proper term for this is called peripheral vascular disease or PVD. The most common cause of PVD is atherosclerosis or “hardening of the arteries”. Diabetes is the most common cause of PVD.
What are the symptoms of poor circulation?
1. Claudication – this is cramping in the legs or feet after walking a certain distance. The pain goes away when you stop walking. The reason you get cramps in the legs is due to leg muscles requiring more oxygen. Since the blood vessels can’t provide the proper amount of oxygen to the muscles, you get cramping.
2. Skin color changes – the skin color becomes more pale, bluish or reddish
3. Numbness or tingling in the foot or toes.
4. Skin temperature changes – the skin feels cool or cold
5. Poor skin – the skin is prone to sores, ulcers and infection
The biggest problem with poor circulation in the feet, is that the blood carries oxygen to the body tissues for healing purposes. If you have a wound, cut, sore, or infection, the blood cannot reach the compromised area of your feet and bring the oxygen or other healing factors present.
Poor Circulation is treated in various ways:
1. Exercise more
2. Treat high blood pressure, high cholesterol and diabetes
3. Stop smoking
4. Use blood thinners to prevent blood clots
5. Surgery to either dilate the blood vessels, or perform a “bypass of the blocked blood vessel.
Foot care is so important if you have PVD. By following these recommendations, you can prevent future problems:
1. Prevent accidents or trauma
2. Wear shoegear that fits well and does not rub sores on the feet
3. Seek professional help from a podiatrist for assitance in trimming of nails, corns and calluses to prevent injury.
Podiatrists can help you with the following:
1. Perform a complete evaluation of your blood flow status and inform you of the risks involved with PVD
2. Help perform periodic reassessment of the blood flow status
3. Give advice on foot care and proper fitting shoegear.
4. Take care of all foot conditions
5. Manage any infections, sores, wounds, or ulcerations on the feet.
If you feel that your foot and leg circulation is poor, please contact Dr. Kory Williams or Dr. Eric Silvers at Advanced Foot & Ankle Center. We can help you with all your foot and ankle needs.
