AllDr. David Levine responds to questions regarding Post-Op Orthoses in an expert four panelist Q&A. Dr. Levine discuses for which conditions he recommends post-op orthoses and the type of benefits patients should expect to see. He indicates that when a patient has a procedure that changes their biomechanical function, orthotic devices should be a postoperative option, as orthotics are a great way to improve function and enhance comfort. Modifications and each orthotic device is specific to the type of surgery and underlying symptom. It is important to be properly evaluated by a podiatrist to find out the best option for your needs. For the full Q&A from all four experts, head over to the Podiatry Today website and learn even more! Dr. David Levine works in our Frederick, MD (Thomas Johnson Dr) office. The information on this site is provided for your assistance only; this site does not provide podiatric advice. You should never diagnose or treat yourself for a podiatric condition based on the information provided herein, and the information is not provided for that purpose. Likewise, you should never determine that treatment is unnecessary based on this information. The information contained herein is not a substitute for podiatric care provided by a licensed podiatric professional. The information provided herein is not podiatric, medical or professional advice. This site does not create a doctor-patient relationship. Dr. David Levine and Foot & Ankle Specialists of the Mid-Atlantic, LLC expressly disclaims all warranties of any kind, whether express or implied, related to any products offered for sale on this web site. Dr. David Levine and Foot & Ankle Specialists of the Mid-Atlantic, LLC further expressly disclaims any product warranties of effectiveness or fitness for any particular purpose or use. You are solely responsible for your use of, or reliance on, any products offered for sale herein, and any consequences arising out of such use or reliance. In no event will Dr. David Levine and Foot & Ankle Specialists of the Mid-Atlantic, LLC be liable for any damages resulting from use of or reliance on any such products, whether based on warranty, contract, tort or any other legal theory. This website, and the information contained herein, is provided to you as a service for use at your sole risk. The snow is starting to fall and the temperatures are dropping. Some people look forward to the chilly weather and others just keep hoping for Spring to come early. No matter which type of person you are, each one of us has to be careful with protecting our feet in the winter. In our region, it seems like it will be a snowy and wet winter which can lead to many hazards for our foot health. One hazard some of us have already had to deal with is the snow and below-freezing temperatures. When the snow starts to fall, many of us slip into our shoes and head out to our driveway to shovel. Snow creates a very wet and slippery environment which can cause many traumatic and thermal injuries. It is always important to remember to wear waterproof shoes/boots and thick warm socks. If you are traveling, make sure you bring an extra change of socks or shoes just in case your original pair gets wet, as this moisture can cause frostbite to occur sooner than it would in a dry environment. Depending on the temperature, wind speed, and amount of moisture, frostbite can take as long as 30 minutes but as quickly as 5 minutes to start affecting the skin of the feet. This can lead to pain, skin discoloration, nerve damage, wounds, or in a worst case scenario, gangrene. With these frigid temperatures comes snow and ice, and unfortunately, all too often we hear of people slipping and falling because of the conditions outside. Falling can be dangerous for people of all ages, and one bad fall can cause fractures, sprains, and other acute foot/ankle problems. If you are a fall risk, it is safest to stay inside until the conditions have improved. If you must go outside, make sure you are wearing shoes or boots with good traction and tread carefully and slowly. For those with diabetes or neuropathy (lack of feeling/sensation) to the lower extremities, it is safest to avoid any and all extreme temperatures. With lack of sensation, you are unable to appropriately sense whether the skin of your feet is safe. If you find yourself outside in the winter weather or snow, please make sure you are appropriately dressed with thick, warm socks and closed-toed, waterproof shoes. Also, make sure you limit the amount of time you are exposed to below-freezing temperatures. Once back in a warm environment, check your feet immediately for any changes, and call your doctor if there are any concerns. It is also important to remember that not only freezing temperatures can cause danger in the winter, but also heat thermal injuries as well. It is not uncommon for people to come back in from the cold weather and immediately want to warm up their feet. Sometimes this is done by dangerous methods such as using heating pads, fireplaces, blow-dryers or scalding hot baths. It is recommended that you avoid rewarming your feet with these methods as these can cause burns to the skin which may lead to serious complications. Lastly, when it's not snowing or sleeting, winter often brings a decreased humidity and dry air conditions, which can cause your skin to become dry and flaky. Sometimes all the layers we put on to keep our feet safe and warm can cause our feet to sweat and once exposed to the dry air can lead to cracking and fissures of the skin. This can be very painful at times and may even cause the skin to bleed. Therefore, in order to avoid these problems, it is important to appropriately moisturize your feet in the winter. When looking for a lotion or cream to use, try to find one that has a thicker base and is unscented. Sometimes it is necessary to apply lotion two times a day if your feet are prone to dryness. If you have any problems or concerns with your feet or ankles, the doctors at FASMA are here to help! Call your local FASMA location and we'll help you keep your feet safe and healthy during these cold winter months.
What is it?The Achilles tendon is the largest tendon in the human body. It is a band at the back of the lower leg that connects the calf muscle to the heel bone. The most common injury to the achilles tendon is achilles tendonitis. Achilles tendonitis is the overuse of the achilles tendon. It commonly occurs in high impact sports such as running, basketball, jumping and tennis.
What will I feel?Some beginning symptoms of achilles tendonitis are stiffness and tenderness in the back of the foot. If overuse of the achilles tendon continues, the pain can become more severed. Some patients report mild pain in the morning, which usually subsides after mild activity occurs. Pain may be aggravated by going up and down stairs.
What will they do?During the physical exam, your doctor will gently press on the affected area. We will determine the location of pain, tenderness or swelling. He or she will also evaluate the flexibility, alignment and range of motion of your foot and ankle.They may be able to palpate a bone spur on the back of your heel. X-rays are ordered to determine if there is an associated bone spur. If a full or partial tear or rupture is suspected, a MRI can be ordered to further guide treatment.
Possible Treatment Options:Achilles tendonitis generally responds very well to conservative treatment as long as it is diagnosed and treated early.
- RICE (Rest, Ice, Compression, Elevation) is a good initial treatment to reduce pain. Icing will help decrease the inflammation and pain in the tendon.
- Heel lifts in the patient's shoes.
- Supportive shoe gear or a low heel.
- Avoid barefoot walking
- Non-steroidal anti-inflammatory drugs (NSAIDS) to calm the inflammatory process in the tendon.
- Stretching exercises for the lower leg to help loosen the calf muscle and Achilles tendon so that the tendon is not under as much stress.
- If the pain is particularly severe, a pneumatic walking boot can be used to immobilize the area to reduce pain and inflammation when walking.
- Custom orthotics to reduce mechanical stresses in the area.
- Physical Therapy can aid in decreased inflammation and increasing flexibility.
- Alternative therapies. These therapies are worth considering for cases that have failed conservative treatment.
- PRP (Platelet rich plasma)
- Amniotic membrane
- Pain lasers
- If the tendon has been ruptured completely, surgery is available
How do I Avoid it?
- Always warm up thoroughly before any exercise.
- Stretch your muscles and tendons every day.
- Evaluate your shoe gear to ensure they are supportive and do not need to be replaced.
- Replace your shoes (especially athletic) yearly
- Do not continue to exercise through the pain
- Do not delay treatment