Tuesday, 09 November 2021 00:00

What is a Podiatrist?

The branch of medicine that is focused on the treatment, diagnosis, and study of disorders of the lower leg, ankle and foot is referred to as podiatry. Because people often spend a great deal of their time on their feet, many problems in this area can occur. A person seeks help from the field of podiatry when they need treatment for heel spurs, bunions, arch problems, deformities, ingrown toenails, corns, foot and ankle problems, infections, and problems with the foot that are related to diabetes and additional diseases.

To treat problems of the foot, ankle or lower leg, a podiatrist may prescribe physical therapy, drugs, perform surgery, or set fractures. Individuals may also be recommended to wear corrective shoe inserts, custom-made shoes, plaster casts and strappings in order to correct deformities.

When trying to gather information on a patient problem, a scanner or force plate may be used in order to design orthotics. During this procedure, patients are told to walk across a plate that is connected to a computer; the computer then takes a scan of the foot and indicates weight distribution and pressure points. The computer readouts will give the podiatrist information to help them determine the correct treatment plans.

Diagnosis is also provided through laboratory tests and x-rays. Through the foot, the first signs of serious problems such as heart disease, diabetes and arthritis can show up. For example, individuals that have diabetes may frequently have problems such as infections and foot ulcers because they experience poor circulation in the foot area. A podiatrist can then have consultations with patients when symptoms arise. Referrals will then be made to specialists that handle the greater health problems.

Some podiatrists have their own independent, private practices or clinics where they have a small staff and administrative personnel. Many podiatrists work within group practices. They usually spend time performing surgery in ambulatory surgical centers or hospitals, or visit patients in nursing homes. Podiatrists typically spend between 30 to 60 hours of week working. Some podiatrists specialize in public health, orthopedics, surgery, or primary care. Other fields include specialties in geriatrics, dermatology, pediatrics, diabetic foot care and sports medicine.

Some podiatrist specialists complete extra training in the area of foot and ankle reconstruction that results from the effects of physical trauma or diabetes. There are also surgeons that perform surgery of a cosmetic nature to correct bunions and hammertoes.

Tuesday, 26 October 2021 00:00

How Does the Ankle-Brachial Index Test Work?

The Ankle-Brachial Index (ABI) test is a screening measure that a podiatrist can use to determine a patient’s risk of having peripheral artery disease (PAD). As many as 50% of people who have PAD are asymptomatic. This makes screenings very important for detection, diagnosis, and treatment. During an ABI test, the doctor uses a blood pressure cuff or ultrasound to take your blood pressure at the brachial artery in both upper arms and at the anterior and posterior tibial arteries in both lower legs. The doctor then takes the higher of the two brachial blood pressures and the highest of the anterior or posterior tibial artery blood pressures and compares the two numbers to form a ratio. This ratio correlates to one’s risk of having PAD. A ratio of 1.0-1.4 is considered within the normal range, while a ratio below 0.90 is considered abnormal. It is said that the lower the ratio, the more severe the PAD. For more information about vascular testing, please consult with a podiatrist. 

Vascular testing plays an important part in diagnosing disease like peripheral artery disease. If you have symptoms of peripheral artery disease, or diabetes, consult with Darren Day, DPM from Hawaii. Our doctor will assess your condition and provide you with quality foot and ankle treatment.

What Is Vascular Testing?

Vascular testing checks for how well blood circulation is in the veins and arteries. This is most often done to determine and treat a patient for peripheral artery disease (PAD), stroke, and aneurysms. Podiatrists utilize vascular testing when a patient has symptoms of PAD or if they believe they might. If a patient has diabetes, a podiatrist may determine a vascular test to be prudent to check for poor blood circulation.

How Is it Conducted?

Most forms of vascular testing are non-invasive. Podiatrists will first conduct a visual inspection for any wounds, discoloration, and any abnormal signs prior to a vascular test.

 The most common tests include:

  • Ankle-Brachial Index (ABI) examination
  • Doppler examination
  • Pedal pulses

These tests are safe, painless, and easy to do. Once finished, the podiatrist can then provide a diagnosis and the best course for treatment.

If you have any questions, please feel free to contact our offices located in Honolulu and Kahuku, HI . We offer the newest diagnostic and treatment technologies for all your foot care needs.

 

Read more about Vascular Testing in Podiatry
Tuesday, 26 October 2021 00:00

Flat Feet

Flatfoot is a foot condition in which the arch of the foot has either partially or totally dropped or has never developed. While it is common in babies and small children, it can become a problem for them in adulthood if the arch never forms. For adults, the development of flat feet can be brought upon by injury, as a result of pregnancy due to increased elasticity, or obesity. Those who have health concerns such as rheumatoid arthritis or diabetes may also be at greater risk for developing the condition.

If you suspect that you have flat feet, it is best to consult your podiatrist. Your foot doctor will examine the suspected foot and observe how it looks while you sit and stand. He or she may take an X-ray to determine how serious the condition is. Some common signs of flatfoot include toe drift, in which the toes and front part of the foot point outward, a short Achilles tendon, and a heel that tilts outwardly while the ankle tilts inward.

Once flatfoot has been diagnosed, your podiatrist may suggest one of several treatment options. Flat feet can be rigid, in which the feet appear to have no arch even when the person is not standing; or flexible, in which the person appears to have an arch while not standing, but once standing the arch disappears. Those with flexible flatfoot may be told to reduce any activities that cause pain and to avoid extended periods of walking or standing. Another suggestion may be weight loss, as excessive weight may be placing pressure on the arches

In few cases, if the condition is severe and all other methods have been exhausted surgery may be required. This is normally avoided, however, due to a lengthy recovery time and high cost.

Tuesday, 19 October 2021 00:00

Let the Expert Treat Your Ingrown Toenails

Ingrown toenails can be painful and can make wearing shoes or walking uncomfortable. Seek professional help if you believe you've developed an ingrown toenail and be treated safely. 

Tuesday, 19 October 2021 00:00

Arthroscopy: A Technological Marvel

In arthroscopic surgery, a small incision in the skin is made to allow a narrow instrument (arthroscope)—with a light and video camera attached—to be inserted into the ankle. The video from the camera transmits a signal to a large screen which the surgeon views to see and diagnose damage inside the ankle. The surgeon can look at this video to guide them during arthroscopic surgery, using tiny surgical instruments inserted through other small incisions. Arthroscopic ankle surgery can be used to restore damage to cartilage, remove bone spurs, scar tissue and debris, and treat certain conditions in the small area at the back of the ankle. Arthroscopic surgery offers shorter hospital stays and recovery time, and it has a lower risk of infection due to small incisions being made—as opposed to larger incisions associated with open surgeries. Make an appointment with your podiatrist to see if arthroscopic surgery is appropriate for your ankle condition.

Foot surgery is sometimes necessary to treat a foot ailment. To learn more, contact Darren Day, DPM of Hawaii. Our doctor will assist you with all of your foot and ankle needs.

When Is Surgery Necessary?

Foot and ankle surgery is generally reserved for cases in which less invasive, conservative procedures have failed to alleviate the problem. Some of the cases in which surgery may be necessary include:

  • Removing foot deformities like bunions and bone spurs
  • Severe arthritis that has caused bone issues
  • Cosmetic reconstruction

What Types of Surgery Are There?

The type of surgery you receive will depend on the nature of the problem you have. Some of the possible surgeries include:

  • Bunionectomy for painful bunions
  • Surgical fusion for realignment of bones
  • Neuropathy decompression surgery to treat nerve damage

Benefits of Surgery

Although surgery is usually a last resort, it can provide more complete pain relief compared to non-surgical methods and may allow you to finally resume full activity.

Surgical techniques have also become increasingly sophisticated. Techniques like endoscopic surgery allow for smaller incisions and faster recovery times.

If you have any questions please feel free to contact our offices located in Honolulu and Kahuku, HI . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Foot Surgery
Tuesday, 19 October 2021 00:00

Foot Surgery

In most cases, foot surgery is often chosen as the last available option for conditions that have otherwise been unsuccessfully treated. Surgery may be necessary for several reasons, including the removal of foot deformities (e.g. bone spurs or bunions), arthritis problems, reconstruction due to injury, and congenital malformations (e.g. club foot or flat feet). Regardless of one’s age, foot surgery may be the only successful option for treatment for certain conditions.

The type of surgery one undergoes depends on the type of foot condition the patient has. For the removal of a bunion growth, a bunionectomy is necessary. If the bones in the feet need to be realigned or fused together, a surgical fusion of the foot is needed. For pain or nerve issues, a patient may require surgery in which the tissues surrounding the painful nerve are removed. Initially, less invasive treatments are generally attempted; surgery is often the last measure taken if other treatments are unsuccessful.

While in many cases surgery is often deemed as the final resort, choosing surgery comes with certain benefits. The associated pain experienced in relation to the particular condition is often relieved with surgery, allowing patients to quickly resume daily activities. The greatest benefit, however, is that surgery generally eliminates the problem immediately.

Podiatry history has shown that foot treatments continue to evolve over time. In the field of foot surgery, endoscopic surgery is just one of the many advanced forms of surgery. As technology vastly improves so too will the various techniques in foot surgery, which already require smaller and smaller incisions with the use of better and more efficient tools. Thanks to such innovations, surgery is no longer as invasive as it was in the past, allowing for faster and easier recoveries. 

Tuesday, 12 October 2021 00:00

Every Day Foot Care

Our feet are important in our everyday lives. The problem is that we tend to neglect them. When this becomes a habit, it can cause significant trouble. Ignoring foot problems can mean pain, limited mobility, and expensive doctor's visits. On the other hand, if feet are cared for and looked after regularly, they will perform without pain or complication.

Routine hygiene is the most basic way to care for the feet. Wash and dry them thoroughly daily. Remember to get between the toes and keep the toenails trimmed and short. If the feet feel dry or there are signs of dryness or cracking, use a moisturizer designed for the feet.

When using moisturizer on the feet, try to avoid applying between the toes. If cream or lotion sits too long, they can cause fungal and bacterial growth. When moisturizer is used between the toes, it can also cause the skin to soften too much.

Shoes are also an important aspect of foot care. When one is picking out shoes, make sure they are the correct size. Shoes need to be snug, but not too tight. On the other hand, if shoes are too loose they can cause foot problems as well. It is highly recommended that shopping for new shoes be done later in the day. The reason for this is that the feet will have settled and swelled to their full size by then. To keep your feet at their most healthy, avoid wearing high heels or flip flops too often. Instead, choose shoes that are good for your feet. Good shoes pad the soles of your feet and support the arches and ankles.

Socks should also be worn daily with closed-toe shoes. They may feel hot during the summer months, but they absorb sweat and moisture off the feet. Without socks, the build-up of sweat in a closed-toe shoe can cause fungal problems and athlete's foot.

The best thing to remember in every day foot care is that shoes do make a difference. If you spend a lot of time on your feet, make sure that your shoes show no signs of wear. Shoes should offer ample support for the arches and the overall foot. Additionally, try to make foot cleaning and maintenance a daily habit. If you keep these things in mind, your feet will stay healthy and safe.

Tuesday, 12 October 2021 00:00

Athlete's Foot

Athlete’s foot is an extremely contagious infection caused by a fungus that results in itching, burning, dry, and flaking feet. The fungus that causes athlete’s foot is known as tinea pedis and thrives in moist, dark areas such as shower floors, gyms, socks and shoes, commons areas, public changing areas, bathrooms, dormitory style houses, locker rooms, and public swimming pools. Athlete’s foot is difficult to treat as well because of the highly contagious and recurrent nature of the fungus.

Tinea is the same fungus that causes ringworm, and is spread by direct contact with an infected body part, contaminated clothing, or by touching other objects and body parts that have been exposed to the fungus. Because the feet are an ideal place for tinea to grow and spread, this is the most commonly affected area.  It is, however, known to grow in other places. The term athlete’s foot describes tinea that grows strictly on the feet.

The most commonly infected body parts are the hands, groin, and scalp, as well as the feet. Around 70% of the population suffer from tinea infections at some point in their lives, however not all of these cases are athlete’s foot. Just like any other ailment, some people are more likely to get it than others, such as people with a history of tinea infections or other skin infections, both recurring and non-recurring ones. The extent to which a person experiences regrowth and recurrent tinea infections varies from person to person.

Sometimes people will not even know that they are infected with tinea or that they have athlete’s foot because of a lack of symptoms. However, most experience mild to moderate flaking, itching, redness, and burning. However, some of the more severe symptoms include cracking and bleeding skin, intense itching and burning, pain while walking or standing, and even blistering.

Because of the recurring nature of the tinea fungus and the athlete’s foot it causes, the best way to treat this condition is with prevention. You can take some preventative measures such as wearing flip flops or sandals in locker rooms and public showers to reduce contact with the floor. It also helps to keep clean, dry feet while allowing them to breathe. Using powders to keep your feet dry is a good idea, as well as keeping your feet exposed to light and cool air, to prevent the growth of tinea. If you do happen to get athlete’s foot, opt for using topical medicated creams, ointments or sprays. These treatments help eliminate and prevent it from coming back.

Poor blood circulation in the feet and legs is often caused by peripheral artery disease (PAD), which is usually the result of a buildup of plaque in the arteries. Plaque buildup, or atherosclerosis, can be the result of excess calcium and cholesterol in the bloodstream. This restricts how much blood can flow through arteries. Reduced blood flow to a certain area of the body severely limits the amount of oxygen and nutrients that part of the body receives. This leads to degeneration in the muscles and other tissues. Sometimes, poor blood circulation in the feet and legs can be caused by other conditions, such as the damaging or inflammation of blood vessels, known as vasculitis.

The lack of oxygen and nutrients caused by poor blood circulation can restrict muscle growth and development, as well as cause muscle pain and cramps, weakness, and stiffness. Other common symptoms include numbness in the legs and feet, skin discoloration in the affected limbs, slower nail and hair growth, and erectile dysfunction in men. In more severe cases of PAD, pain can be present even when a person isn't exercising, and may range from mildly uncomfortable to completely debilitating.

Poor blood circulation in the feet and legs is more common in those who are overweight or obese, have diabetes, high blood pressure, high cholesterol, who smoke, or who have a family history of PAD or related conditions such as a heart attack, stroke, etc. Diabetes and smoking place a person at greatest risk for developing poor blood circulation, although advanced age, over 50, can also increase risk.

If you are experiencing poor blood circulation in the feet and legs caused by PAD, it is important to make changes to your lifestyle in order to reduce your risk of experiencing a heart attack or stroke caused by this condition. If you smoke, quit completely. This will increase the amount of oxygen in your bloodstream. Exercising and reducing the saturated fats in your diet. Saturated fats come from fatty meats, fried foods, whole milk, etc., can make a difference in improving blood circulation in feet. It is also important to avoid developing influenza and to carefully control your blood sugar if you have diabetes.

Your doctor may recommend combining lifestyle changes with a prescription medication regimen to improve blood circulation. The most commonly-used medications for PAD are called statins and work by blocking the amount of enzymes in your body that produce cholesterol. They are known by the brand names Zocor, Lipitor, Crestor, and others.

Tuesday, 05 October 2021 00:00

Ankle Sprains

Although ankle sprains may not be as serious as a broken ankle, they should be given immediate attention and care. An ankle sprain can lead to a significant amount of pain, as well as limited mobility. They are often characterized by the swelling and discoloration of the skin. This occurs when the ligaments are stretched beyond their limits.

The simple act of walking can sometimes cause a sprain, which makes ankle sprains a very common injury that can happen to anyone. They occur when the ankle twists in an awkward way or rolls over itself, causing a pop or snap in the tendons around the ankle. Some people are more at risk than others. These include athletes who continually push their bodies to the limits and also people who have previously suffered accidents to the feet, ankles, or lower legs.

Most of the time, an ankle sprain is not severe enough for hospital attention. There are many at-home treatment options available, including propping the leg up above your head to reduce blood flow and inflammation, applying ice packs to the affected area as needed, taking over-the-counter pain relievers and anti-inflammatory medication, using an ACE bandage to wrap and support the injured ankle, and most importantly, remaining off your feet until the ankle has fully healed.

Despite this, an ankle sprain can turn into a severe injury that might require hospitalization. If the ankle ligaments or muscles are damaged from a tear or rip, that is one sign that the sprain is severe enough for hospital attention and possibly for surgery. Even after the surgery, the recovery process can be long. You may need to have rehabilitation sessions administered by your podiatrist to get your ankle back to full health.

The severity of your sprain might become apparent if you are unable to stand or walk, consistent pain occurs over a prolonged period of time, swelling is much more severe than initially present, or if you start to experience tingling or numbness. These signs may indicate that your ankle sprain might actually be a broken ankle, an injury that requires immediate medical attention.

Although they are not completely avoidable, ankle sprains can be curbed with some preventative treatment measures. These include wearing appropriate-fitting shoes that not only provide a comfortable fit, but also ankle support. It is also recommended to stretch before doing any kind of physical activity, as this will help lower your body’s chance for an injury.

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Advanced Podiatric Procedures & Services in the Honolulu County, HI: Honolulu (Manoa, Kaneohe, Waikiki, Aiea, Waimalu, Moanalua, Kailua, Maunawili, Pearl City, Waipahu, Ahuimanu, Hawaii Kai, Waialae - Kahala) and North Shore (Kahuku, Laie, Hauula, Kawela Bay, Pupukea, Punaluu, Kaaawa, Haleiwa, Waialua, Koolauloa) areas