Don't be like Brady!

You don't have to be a football fan to know that the New England Patriots are no longer contenders for the Super Bowl this year. News of their seven point, playoff loss to the New York Jets spread like wildfire. Not as widely known, however, is that Patriots quarter back Tom Brady was battling a stress fracture in his right foot all season. He played through the pain all year and only went in for surgery to repair the injury when Super Bowl XLV was out of the picture. In this way, Brady is so much like the rest of us whether we want to admit it or not. Love him or hate him, you're just like him because you probably postpone visiting the doctor until absolutely necessary.
So many of us either try to work through pain or diagnose and treat ourselves. I can't tell you how many times I've found one reason or another to put off seeing my doctor about a health issue. All too often I hear "I don't have time to go to the doctor" or "I'd have to leave work early to get this looked at." It's scary how common this phenomenon is because our health isn't something that we should gamble with. Untreated injuries or illnesses can often develop into something much more serious than the original problem. That pesky ingrown can lead to a dangerous infection. That painful foot injury might need surgery but then again it might not. The point is that you won't know until you get it looked by a professional.

Make time. Leave work early. Schedule an appointment to see Dr. Feeny or Dr. Yeaman. Your feet will thank you for it and you'll save yourself a lot of grief in the long run.

Winter Tips for Cold Feet

Brrr! Winter is in full force here in the valley and that means it’s COLD. During this time of the year we often pile on layers to protect our core but tend to forget about our extremities. If you’re looking for tips on how to keep your feet warm this winter, Shenandoah Podiatry can help.
Socks made from natural fibers – like wool – should be worn because they have moisture-wicking properties. This helps to prevent fungus which grows best in warm, damp places. Leather shoes can also keep your feet warm because leather has natural insulating properties. If you choose to wear insulated boots, be sure that they aren’t too tight as this can cause ingrown toenails. Avoid electric socks and other heated inserts because they can be dangerous especially if there’s an underlying reason for your cold feet.

Aside from winter weather, cold feet can be caused by a number of serious ailments that should be addressed right away. If our feet are cold year-round, we might be especially quick to write it off as normal during the winter. Unfortunately, cold feet can be indicative of a more serious problem and should never be ignored.

Peripheral vascular disease (PVD) or poor circulation is a common culprit. Blood helps to keep us warm and without proper circulation our bodies direct heat to our core and away from out feet. If you smoke or have diabetes, you have an increased risk of developing PVD which can make it harder for small cuts and ulcers to heal properly. This is why it’s so important to see a podiatrist right away if one of these sores develops.
Diabetes can also put you at risk for chilbains or ulcers of the toes and feet after cold exposure. If you experience redness and swelling in your toes after being outside and it doesn’t go away once they’ve warmed, make an appointment to see us right away.
We hope that you’ll follow these tips and be on the lookout for these possible conditions. If you do, you’ll find it easier to keep your feet warm this winter which is important because warm, dry, pain free feet are healthy feet.

A Shoe For Every Sport

Shoes, shoes, and more shoes. There seems to be a shoe designed for every sport out there. But
there’s a method to the madness. Sport-specific shoes really can change your game. See the tips
from the APMA below to learn why the shoe you choose could make or break your day on the court or field.

Basketball

Whether you’re making the perfect pass or finishing off the high-flying dunk, basketball shoes have several features that will help you prevent injury.

• A thick, stiff sole gives support while running and landing from jumps.

• High ankle construction supports the ankle during quick changes in direction. A basketball shoe should have the strongest support on either side of the ankle.

Racquetball/Tennis

On the surface, court shoes for tennis and racquetball may look like any other athletic sneaker, but it’s what’s on the inside that makes the difference.

• A court shoe supports both sides of the foot because of all
the quick lateral movements and weight shifts in court sports.

• It provides a flexible sole for fast changes of direction.

• It has less shock absorption than a running or basketball shoe.

Running

The running shoe is perhaps the most personal and intricate
of all athletic shoes. Every runner has different needs and there
are a multitude of choices out there.

• A running shoe must provide maximum shock absorption to help
runners avoid ailments such as shin splints and knee pain.

• The shoe should control the way your heel strikes the ground, so
the rest of your foot can fall correctly.

• Know your foot type (high, medium, low arch) so you can get the
shoe with the right support for your foot.

“Generally, you want to go with the sport-specific shoe if you are participating
in a sport on a regular basis (2-3 times a week). Make sure the shoe fits correctly. Fit is just as important as the right type of shoe,” says APMA Director of Scientific Affairs Dr. Jim Christina.

To read more articles about shoes and your feet, check out the Footnotes link on our website at http://www.roanokefoot.com/.

Running for Women: An Uphill Trend

According to Running USA, over 10 million people finished a race last year. Running has taken on a huge growth in general over the past couple of years. Research shows that running as a form of exercise tends to increase in a bad economy, and with our economic situation running can be an appealing alternative to paying large sums of money for gym memberships.

However, money isn't the only reason for this increase. Many women run for the social aspect. "There's about 10 of us that will travel somewhere in the US. We'll say, 'This is where we're gonna go,' and we all pitch in and we get hotel rooms for all of us," says runner Hillary Mancuso.

Running is an excellent, inexpensive, effective form of exercise. So grab a pair of well-fitted and supportive running shoes, fill up a water bottle, stretch and warm up your muscles, and most of all have fun!

To read more, visit the article from WRCBtv Chattanooga News at http://www.wrcbtv.com/Global/story.asp?S=13628789.

Rheumatoid Arthritis

Rheumatoid arthritis is a chronic systemic inflammatory disease of unknown cause that primarily affects the peripheral joints in a symmetric pattern.

RA causes joint destruction and thus often leads to considerable morbidity and mortality.

Why do people Get RA ?

- An infectious etiology has been speculated
- Associated with a number of autoimmune responses
- Whether autoimmunity is a secondary or primary event is still unknown
- RA has a significant genetic component

Frequency :

The worldwide incidence of RA is approximately 3 cases per 10,000 population

Mortality/Morbidity:

- Daily living activities are impaired in most patients
- Life expectancy for patients with RA is shortened by 5-10 years

Signs and Symptoms:

- Morning stiffness
- Arthritis of 3 or more joint areas
- Arthritis of hand joints - At least one swollen area
- Symmetric arthritis with simultaneous involvement
- Rheumatoid nodules

Progression of RA :

Stage 1 (early RA)

- No destructive changes observed on x-ray
- Radiographic evidence of osteoporosis possible

Stage II (moderate progression)

- Radiographic evidence of periarticular osteoporosis with or without slight subchondral bone destruction
- Slight cartilage destruction possible
- Joint mobility possibly limited; no joint deformities observed
- Adjacent muscle atrophy
- Extra-articular soft tissue lesions (eg, nodules, tenosynovitis)

Stage III (severe progression)

- Radiographic evidence of cartilage and bone destruction in addition to periarticular osteoporosis
- Joint deformity
- Extensive muscle atrophy

Stage IV (terminal progression)

- Criteria of stage III
- Fibrous or bony ankylosis - stiffness of a joint due to abnormal adhesion and rigidity of the bones of the joint

Remission:

Remission of RA - Five or more of the following conditions present for at least 2 consecutive months:

- Duration of morning stiffness not exceeding 15 minutes
- No fatigue
- No joint pan
- No joint tenderness or pain with motion
- No soft tissue swelling in joints or tendon sheaths
- ESR of less than 30 mm/h for a female or less than 20 mm/h for a male

Lab Studies:

No pathognomonic test is available to help confirm the diagnosis of RA. The diagnosis is made using clinical, laboratory, and imaging features. Clinicians will analyze the following:

- Markers of inflammation, such as ESR and CRP
- Synovial fluid analysis
- Rheumatoid factor - Present in approximately 60-80% of patients with RA over the course
- Antinuclear antibodies - These are present in approximately 40% of patients with RA

Treatments:

Disease-modifying antirheumatic drugs:
- Leflunomide (Arava)
- Methotrexate
- Sulfasalazine
- Etanercept (Enbrel)
- Infliximab (Remicade)

Nonsteroidal anti-inflammatory drugs

Analgesics

Glucocorticoids

Immunomodulators:

- Anakinra (Kineret)
- Abatacept (Orencia)

Attention avid golfers

Are you ready for another season of birdies, pars and bogeys? If so, you should know about potentially serious foot problems that can result from years of playing the game.

Although golf is not considered a rigorous sport, the physical act of repeatedly swinging a golf club can lead to a condition known as hallux limitus, a jamming and deterioration of the big toe joint. The movement and weight transfer that occur during the swing's follow through can cause this problem and other chronic foot ailments.
When golfers follow through, they can overextend the big toe joint on their back foot. Those who have played the game for several years eventually can wear out the cartilage or jam the big toe joint. The likely outcome, if left untreated, is painful arthritis in the big toe, which would make it very difficult to continue playing.

If you have pain and swelling around the big toe joint or have less mobility in this area than other parts of the foot, schedule an appointment for an examination. A history of trauma to the big toe area and bone structure also can precipitate the condition. Individuals with a long first metatarsal bone (big toe), for example, are more susceptible to joint compression and hallux limitus. In most situations, orthotics can be prescribed to provide relief, but advanced cases may require surgery.

Check Those Golf Shoes!

Another foot problem that is common in golfers is a neuroma or pinched nerve at the bottom of the foot. The weight transfer to the front foot that occurs in the follow through applies pressure that, over time, can cause a pinched nerve. Wearing shoes that have a spike located directly beneath the ball of the foot can worsen the problem. Also, pressure from that single spike, magnified by the several thousand steps taken during an average round, can cause intense pain and swelling in the ball of the foot. Your golf shoes can be made more foot-friendly, without sacrificing traction, simply by removing poorly located spikes.

For more information visit our website www.roanokefoot.com

COMMON FOOT INJURIES IN ATHLETIC KIDS

Millions of kids are involved in several sports, which is a good thing overall. But because many sports are hard on the feet--- and a child's bones, ligaments, and tendons aren't fully developed, stress-related foot injuries are common. Heel growth plate inflammation, a risk until age 13 to 16, can occur due to muscle strain and repetitive stress. Achilles tendonitis occurs most often after age 14 and results from stressful running and pounding. Tendo-Achilles bursitis is an inflammation of the fluid-filled sac between the Achilles tendon and heel bone. Plantar fasciitis is heel pain triggered by inflammation along the tissue spanning the sole of the foot. Stress fractures and hairline bone fractures caused by overuse.

Young or old, athletically inclined or not, no one can afford to play games with foot injuries, fractures, diseases, or disorders. Podiatric problems demand the attention of a professional. Don't let foot concerns keep you on the sidelines. Consult with us instead at SHENANDOAH PODIATRY . We offer treatment of specific problems as well as preventive care to keep you on your feet. Please call us for an appointment. Same day appointments are often accommodated.

Dedicated To Your Healthy Feet,

Dr. Jennifer Feeny

P.S. Do not allow your child to continue playing a sport if he or she is in pain. Find out the cause of it to prevent chronic problems.