All

MoCo365 Features FASMA

Dr. David Freedman, a founding member and Vice President of Foot and Ankle Specialists of the Mid-Atlantic, is featured on MoCo365. This initiative highlights businesses from all sectors of Montgomery County, Maryland with the purpose of showing the diversity of the area through the stories of successful leaders, entrepreneurs, and inventors. While FASMA began in MoCo, it has expanded throughout the Mid-Atlantic with 35 offices reaching from Pennsylvania to North Carolina. Learn more about our history and what makes us unique by watching this video.  

Injuries to Your Toenails

What are some possible causes of toenail injury?

Everyday injuries can cause your toenail to fall off. Hitting your toe on a chair or bedpost, dropping something on your foot, or simply pulling your socks on too fast can damage your toenail. Injuries to the nail may lead to a subungual hematoma, which causes blood to collect under your injured toenail. This can delay growth of the toenail and be painful for the first few days or weeks. If it can be tolerated, the best way to treat it is to soak the area in cold water for 15 minutes, clean the area with betadine or an alcohol swab, apply antibiotic cream, and trim straight across the toenail. If the subungual hematoma extends to a little over a quarter or half of your toenail, then you must seek treatment at a doctor’s office. If you experience throbbing or severe pain near the hematoma, your doctor will determine if the hematoma needs to be drained to relieve the pressure.  X-rays may also be taken to make sure a fracture has not occurred. In diabetics, or immune-compromised patients, care is important so that infections do not occur. Keep in mind, toenail growth will slow down significantly after the injury. It can take anywhere from six months to two years for the nail to completely grow back. Pressure on the toenail can cause it to weaken and lift off the nail bed. Make sure other toenails are trimmed neatly and wear well-fitting shoes to prevent any future injuries. A half centimeter of room should always be present in the front of shoes to prevent pressure of toenails. A good shoe store can help fit your shoes and make sure you are not feeling extra pressure around your toenails. It is also possible to develop a fungal infection of the nail after a toenail injury. The injury provides an invitation for fungus to grow between the nail bed and loose toenail. If this occurs, your doctor should take a sample of your toenail to confirm that it is fungus, and then treat accordingly. Your doctor will discuss when antifungal medications are necessary on a case by case basis, depending on the results of a nail biopsy. People who have athlete’s foot and diabetes are prone to fungal infections. Diabetic patients have a harder time fighting off a fungal infection and must take extra precaution. Another cause of toenail detachment is psoriasis, an autoimmune condition. With psoriasis, the skin cells begin to build up at a faster rate and cause the toenail to lift off. Many cases of nail psoriasis are mild and don’t persist. Some of the symptoms may include thickening/pitting of nails, unusual nail shape, yellow-brown discoloration, or a chalky-like buildup. If the foregoing remains an issue, your doctor may prescribe topical steroids to rub into your toenail and cuticle.  

What to do when your toenail is injured or falls off.

Step one: Don’t panic. If your toenail starts to fall off, you must follow a few basic tips to avoid worsening your prognosis.
  • First, clean the area with an antiseptic agent as tolerated.  
  • Second, apply an antibiotic ointment with a band-aid. If part of your toenail has fallen off or is detached, it is wise to let a doctor remove the remaining portion to avoid more pain or exposing your nail bed to infection.  
    • Do not lead the band-aid on all day and night-- leave the band-aid on during the day, but leave your toe open at night to let the area get some air.
    • Change your band-aid regularly regularly-- a dark, moist environment creates a way for infection and fungus to form.
  • Also, the doctor will determine how much of your toenail to remove, depending on how much of the toenail is detached.
Do not wait to seek treatment until your entire toenail falls off. While these tips provide a basic understanding of toenail injuries and detachment, they are not substitutes for medical treatment, especially if the pain persists or you are unsure about how to proceed. In such cases, please contact your doctor.   Foot and Ankle Surgeon Dr. Reema DuaDr. Reema Dua works in our Rockville, MD 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. Reema Dua 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. Reema Dua 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. Reema Dua 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.

FASMA Docs Recognized for Sports Med Care

Congratulations to 9 of our doctors, who were declared the “Best of Washington” in the June 2018 issue of Washingtonian Magazine! Each year, the magazine sends out a survey to doctors in the Maryland, Virginia, and DC region to vote for their peers, which results in their Top Docs list. The doctors featured in the June “Best of Washington” issue were compiled from their annual Top Docs list and emphasized which doctors to turn to if you’re facing a sports-related injury. The following doctors have been named to the list of the DC area’s Top Docs for Sports Injuries:

Ian Beiser, DPM

Man Cho, DPM

Lee Firestone, DPM

Eric Masternick, DPM

Gene Mirkin, DPM

Howard Osterman, DPM

Seth Rubenstein, DPM

Erika Schwartz, DPM

Adam Spector, DPM

  Thank you to our patients who entrust us with your care, and to our professional colleagues for their continued and generous vote of confidence.

Fall Risk in Older Adults

Fall Prevention

Fall prevention is not a sexy topic but as we get older (> 60 years of age) physical changes, health conditions and medications can make falls more likely. Stepping on a crack and breaking your mother’s back, is an old childhood game that we didn’t take too seriously.  Something we should take seriously: the 1 year mortality rate for seniors over the age of 60 after a hip fracture is between 14 - 58%. Therefore fall risk prevention is of utmost importance.  

Footwear Style and Risk of Falls in Older Adults

The results of a study reported in the Journal of the American Geriatrics Society 16 August 2004 showed that athletic and canvas shoes (sneakers) were the styles of footwear associated with lowest risk of a fall. Going barefoot or in stocking feet was associated with sharply increased risk. Relative to athletic/canvas shoes, other footwear was associated with a greater likelihood of falling, varying somewhat by style. What this means: Contrary to findings from gait‐laboratory studies, athletic shoes were associated with relatively low risk of a fall in older adults during everyday activities. Fall risk was markedly increased when participants were not wearing shoes.

Fall‐Risk Assessment and Management in Clinical Practice: Views from Healthcare Providers

Another study reported in the same edition of the Journal of the American Geriatric Society from the August 16, 2004 revealed the following: healthcare providers were most likely to report directly intervening with or referring older patients for gait and transfer impairments and balance disturbances and least likely to do so when encountering foot or footwear problems and sensory or perceptive deficits. Patient compliance was the most commonly reported barrier to successful direct intervention across several risk factors, whereas inadequate availability of other healthcare providers and lack of Medicare reimbursement were the most commonly reported barriers to successful patient referrals. What this means: see your podiatrist for foot or footwear problems and any problems with numbness or loss of balance as these are the key areas that are being overlooked by other health providers.  

Begin Fall Prevention now:

  1. Make an appointment with your Podiatrist for Fall Risk Assessment: (bring with you the following information)
    • Medications - that make you tired or affect your thinking
    • Previous falls - have you fallen before, near misses where you caught yourself or someone else caught you
    • Health - dizziness, joint pain, shortness of breath or numbness in feet and/or legs, loss of balance, weakness
  2. Physical activity
    • Develop a walking, water workouts, tai chi program in conjunction with your podiatrist and physical therapist.
  3. Appropriate shoes
    • Wear shoes with firm non-skid, non-friction soles.
    • Avoid wearing loose-fitting slippers that could cause you to trip.
    • Do not walk around barefoot or in your stocking feet. Your podiatrist will help you select or will prescribe appropriate shoes that will not add to your fall risk
  4. Remove hazards to make your home safer
    • Remove loose items from walkways, move furniture like coffee tables
    • Secure loose floor coverings, repair loose flooring, store things you use regularly in an easy to reach place
    • Immediately clean spills
    • Use non-slip mats in bath or shower
    • Do not take chances! Stay away from a freshly washed floor. Never stand on a chair or table to reach something that is too high.
  5. Keep your living space well lit.
  6. If your doctor suggests that you use a cane or a walker to help you walk, please use it! This will give you extra stability when walking and may help you avoid a bad fall. Use assistive devices and get help learning to use them.
  7. Do not use stairs without rails on both sides for support. If you must carry something while you are going up or down, hold it in one hand and use the handrail with the other.
  8. Know your limitations.
  9. See your physician if you have dizzy spells or fainting spells; see your eye doctor at least once a year and have your hearing tested too.
  10. When you get out of bed in the morning or at night to use the bathroom, sit on the side of the bed for a few minutes before standing up. Moving too quickly can make you dizzy, and you might lose your balance and fall. If your feet are numb from neuropathy they don’t know where they are so turn on the lights and look them onto the floor.

What to do if you fall

If you fall at home, remember:

  • Step 1. Stay quiet for a moment — don’t panic
  • Step 2. Decide whether or not to try to get up.

If you decide to try to get up:

  • Step 1. Use strong, stable furniture for support as you try to get up.
  • Step 2. Take some time to recover from your fall after you get up.
  • Step 3. Tell someone that you had a fall.
  • Step 4. Get medical advice if necessary.

If you cannot get up, or if you decide not to try:

  • Step 1: Slide or crawl to get help if you can. You might be able to reach one of the following:
      • Telephone
      • Door to the outside
      • Personal alarm device
      • Something to make a loud noise
  • Step 2: Tell someone you have fallen and need help.
  • Step 3: After calling for help, lie quietly until help arrives. Keep as warm and comfortable as you can.
  • Step 4: Get medical advice if necessary.
  Foot and Ankle Surgeon Dr. Gregoy SmithDr. Gregory Smith works in two offices for your convenience-- Gettysburg, PA and Hagerstown, MD. 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. Gregory Smith 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. Gregory Smith 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. Gregory Smith 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.

Which Way’s the Beach, Bro?

We made it to June!  Can you smell the summer warmth in the air? With the summer, comes dreams of sitting by the pool, going to the beach, outdoor hikes, and long bike rides. June also happens to be Men’s Health Month! The purpose is to create awareness of preventable health problems and injuries among men and boys and encourage them to seek regular medical advice and early treatment. It is well established that males typically have less flexibility than females. Testosterone, a male sex hormone, plays a pivotal role in muscle size and flexibility. It increases the size and mass of muscles on the skeleton. This means that men are going to naturally be “tighter.” This muscle tightness and limited flexibility can lead to lack of normal range of motion at certain joints, inability of tendons to stretch to their full capacity, and lead to injury. Every year, as winter comes to an end, the weight room fills up with men dreaming of, and working toward, their perfect beach bodies. As your muscles get bulkier and more toned, the tendons attached to those muscles become less flexible.   In the lower extremity, the most common muscle tightness that we see is in the calf muscle. The calf is made up of 2 muscles, the gastrocnemius and the soleus. These muscles combine to form the Achilles tendon. This muscle group spans from above the knee, where the gastrocnemius starts, and ends at the Achilles insertion on the back of the heel bone. This muscle group controls almost all of the range of motion at the ankle and secondarily controls the motion of the foot. During walking, running or jumping, the calf muscle pulls the heel up to allow forward movement. As a foot and ankle specialist whose majority of the day is spent treating sports injuries, I can say that almost all of the injuries and chronic conditions that I treat stem from lack of flexibility in the calf and Achilles tendon.   When the calf and Achilles tendon are tight, motion at the ankle is restricted and it causes our foot to naturally compensate for this by overpronating. This leads to increased flexibility in the other small joints of the foot that shouldn’t normally have that amount of range of motion. If these compensations persist, it can lead to injury. The common injuries I see that stem from a tight calf and Achilles tendon in men and boys are:
  • Calf strain
  • Achilles tendinitis
  • Peroneal tendinitis
  • Plantar fasciitis
  • Calcaneal apophysitis (Sever’s disease)
  • Metatarsalagia
  • Sesamoiditis
  We are all victims of not taking enough time to stretch-- but men especially. Stretching to maintain the flexibility in the joints and tendons is the key to preventing injuries.  Stretching before, but more importantly, AFTER exercise can go a long way.   Shown below are my favorite stretching exercises to get into the habit of doing.         Foot and Ankle Surgeon Dr. Erin Robles-ShermanDr. Erin Robles-Sherman works in two offices for your convenience-- Washington, DC (K Street) and Chevy Chase, MD. 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. Erin Robles-Sherman 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. Erin Robles-Sherman 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. Erin Robles-Sherman 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.

How to Treat Hypertension with Running

Dr. Alan Boehm Podiatrist Foot and Ankle Specialists of the Mid-Atlantic Dr. Alan Boehm runs a 5K in Castaway Cay, Bahamas.
So your doctor has given you the diagnosis of hypertension and recommended some lifestyle modifications and changes. One of them likely is to exercise. One of the easiest and greatest ways to exercise is running. It also can be inexpensive compared to other sports activities or joining a gym. Get a good pair of running shoes and you are good to go. Keep in mind, the running shoe is a very important part of equipment to help keep you running pain free. There are stores where you can get a great deal as well as online, but a true running store is your best bet, at least for that first pair. Most new runners are not going to know what shoe is best for them. Controlling or cushion. Trail or running flats. I often have patients tell me they are intimidated by running stores, but they are full of information and often staffed by runners who will help get you dialed in to the right shoe.
Dr. Alan Boehm Podiatrist Foot and Ankle Specialists of the Mid-Atlantic Dr. Alan Boehm and his wife, who both competed in the Raleigh Half Marathon, are pictured with their two children.
You might want to start running but have foot or ankle pain. Before you start that running program, make an appointment with a foot & ankle specialist for an exam and treatment plan. Even if you just have some questions about your feet, in general. Better to tackle minor problems before they become major problems that could sideline your training plan. So, if you get that dreaded diagnosis of hypertension and you want to start running to improve your fitness and avoid medication, keep in mind the importance of good-fitting running shoes and the health of your feet and ankles. Please contact us today if you have any foot or ankle concerns for an appointment to help you get in good running shape. Our goal is to keep you active and pain free!           Foot and Ankle Surgeon Dr. Alan Boehm, JrDr. Alan Boehm, Jr. works in two offices for your convenience- Raleigh, NC (Blue Ridge) and Raleigh, NC (Millbrook). 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. Alan Boehm 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. Alan Boehm 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. Alan Boehm 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.

What is a Sesamoid?

Doctor, why do I have this nagging pain underneath my big toe joint?

Have you ever heard of a Sesamoid injury? Let’s take a closer look at this problem.  

Let’s start at the beginning…  What exactly are sesamoids?

A sesamoid is a bone embedded in the tendons that course below your big toe joint. Sesamoids are found in several joints in the body. Your kneecap, or patella, is another example. Acting as a fulcrum point, the sesamoids help the big toe move normally and provide leverage when the big toe “pushes off” during walking and running. The sesamoids also serve as the weight-bearing interface for the first metatarsal bone. As such, they absorb the weight placed on the ball of the foot in motion.  Sesamoid injuries encompass a variety of disorders involving tendons, bones, ligaments and/or surrounding tissues.  

Who is most likely to get an injury to the sesamoid complex of the foot?

Sesamoid injuries often are associated with activities that tend toward increased pressure on the ball of the foot, such as running, basketball, football, golf, tennis, and ballet. Repetitive use in the same position (loading the big toe joint) can lead to inflammation and even fractures. People with high arches are also at risk for developing sesamoid injuries.             

The three types of sesamoid injuries in the foot:

  • Sesamoiditis:  This is an overuse injury involving chronic inflammation of the sesamoid bones and the tendons involved with those bones. Sesamoiditis is caused by increased pressure or traction forces around the sesamoids. Sesamoiditis is commonly reported as a dull, longstanding pain beneath the big toe joint. The pain comes and goes, usually occurring with certain shoes or certain activities.
  • Fracture:  A fracture (break) in a sesamoid bone can be either acute or chronic. An acute fracture is caused by trauma – a direct blow or impact to the bone. An acute sesamoid fracture produces immediate pain and swelling at the site of the break, but usually does not affect the entire big toe joint. A chronic fracture is a stress fracture (a hairline break usually caused by repetitive stress or overuse). A chronic sesamoid fracture produces long standing pain in the ball of the foot beneath the big toe joint. The pain, which tends to come and go, generally is aggravated with activity and relieved with rest.
  • Turf toe:  This is an injury of the soft tissue surrounding the big toe joint. Turf toe causes immediate, sharp pain and swelling.  It usually occurs when the big toe joint is extended beyond its normal range. It usually affects the entire big toe joint and limits the motion of the toe.

What should I do if I think I have sesamoid problems?

If you have pain, swelling, or bruising below the big toe joint, it may be a sesamoid issue. It all begins with a test. The x-ray is the most common and widely used first diagnostic test for this injury. During an exam, your foot and ankle doctor will examine the foot, focusing on the big toe joint. Your doctor will press all around the big toe, move it up and down. Your walking may also be assessed.

How is a sesamoid injury treated?

At-home remedies can include wearing stiffer shoes, icing the area, and avoiding wearing heels. In most cases, at FASMA, our podiatrists will recommend a non-surgical treatment for sesamoid injuries to be first attempted. Depending on your doctor’s exam this may include: Immobilization, oral nonsteroidal anti-inflammatory drugs (NSAIDs), orthotic devices, physical therapy, and padding, strapping, or taping When sesamoid injuries fail to respond to non-surgical treatment, steroid injections or surgery may be required. Your foot and ankle surgeon will determine the type of procedure that is best suited to your individual needs. Dr. Stewart Chang works in two offices for your convenience: Charlottesville, VA (Rio East Ct) and Fishersville, VA. 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. Stewart Chang 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.Stewart Chang 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. Stewart Chang 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.

APMA Video Interview with Dr. Rubenstein

Dr. Seth Rubenstein fields questions on Facebook regarding foot and ankle health. Dr. Rubenstein is the Vice President of the American Podiatric Medical Association (APMA). Based on an APMA survey of over 1,200 US adults ages 18 to 75, over 75% of those who responded have had foot pain. Almost half of the respondents experienced more than one painful foot condition and over 81% of obese respondents have experienced foot pain. Learn more about foot pain and podiatry by watching the video below. Foot pain is not normal. If you're experiencing foot pain, be sure to make an appointment with a podiatrist.  

Stress is Everywhere– Even in our Feet

April 2018 is National Stress Awareness Month. Earlier this month on our Foot Doctor Blog, we featured how stress impacts the entire body and gave ways to combat stress. Being specialists in foot and ankle health, this article will specifically detail how stress impacts the feet. Foot Stress Stress affects all of us in many ways: it can heighten our level of excitement and it can weigh us down and even make us sick. Physical stress can take its toll on our feet in the form of excessive wear and tear of the nails and skin and show up as overuse injuries like tendinitis or bone stress fractures. Excessive emotional stress or anxiety can have more subtle symptoms and be felt all the way to our toes. Many people may endure restlessness of the legs that disturbs their sleep or tensing of muscles that may adversely affect their gait. An anxiety attack involving hyperventilation and a sudden release of adrenaline in the body moves blood away from your feet and may produce uncomfortable burning and numbness, cold feet and even hyperhidrosis (sweating). The mind-body connection is powerful and must be considered when dealing with all injuries and illnesses. Being over-stressed results in perceived hypersensitivity and more painful symptoms that would normally not elicit such a response. Negative stress can negatively affect treatment outcomes, resulting in poor compliance, more discomfort, delays in healing, and a higher rate of complications. Stress cannot be ignored. As podiatric physicians, we evaluate and consider the entire person, not only focusing on their foot problem in order to enjoy optimal results.  
Dr. Gina M. Saffo works out of two offices for your convenience: Annapolis, MD and Greenbelt, MD.
Dr. Adam K. Spector works out of two offices for your convenience: Rockville, MD (Shady Grove Rd) and Wheaton, MD.
  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. Drs. Saffo and Spector 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. Drs. Saffo and Spector 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 Drs. Saffo and Spector 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.

Don’t Let Stress Get to You

April 2018 is National Stress Awareness Month. Health Care Professionals and Public Health Experts will promote public awareness of the causes, signs/symptoms, and treatment options for managing stress. Stress affects us all. It is defined as our body’s way of responding to a demand or threat, whether physical or emotional. Physiologically, our nervous system releases stress hormones, such as cortisone or adrenaline, that initiate a “fight or flight” response. This manifests as symptoms of increased blood pressure, faster breathing and heart rate, and muscle tightening. These physical changes can then increase strength/stamina, reaction time, and enhance focus. Causes of stress can include physical, such as chronic illness or injury, or mental, such as anxiety or fear. Emotional causes of stress can include work-related stress (losing a job), financial worries (paying off debt), and changes to interpersonal relationships (divorce or losing a loved one). Chronic physical or emotional stress, if not handled correctly, can lead to more serious health problems: an increase in heart attack or stroke, suppression of the immune system, weight problems, sleep issues, skin conditions, prolonged pain or fatigue, and digestive and reproductive issues. Chronic stress can leave a person more vulnerable to anxiety, depression, and feelings of isolation. There are simple ways to combat stress and these can be managed either through personal changes or by seeking medical attention.
  1. Exercise: Research has shown that just 30 minutes a day of cardiovascular exercise can help boost mood, reduce cortisol levels, and improve clarity and focus.
  2. Diet: Eat a diet rich in fresh fruit and vegetables, lean protein, and omega-3 fatty acids to reduce cortisone levels and boost the immune system and lower heart disease.
  3. Sleep More: Sleep allows our brain to re-charge, repair muscle, and improve memory. Adults who get at least 8 hours of sleep at night are more likely to have improved memory, energy, and motivation during the day to manage daily stresses.
  4. Relax and Connect: Practice yoga, meditation, and deep breathing to boost levels of joy, serenity, and calm. Ask for help from family, friends, community groups, or religious organizations to provide emotional and other support.
  5. Talk to Your Doctor: If stress is creating health issues, address them early on with a medical practitioner. Intervention can include prescription medication, nutritional support, counseling, and support groups.
  Dr. Saylee Tulpule works in two offices for your convenience- Silver Spring, MD (Fenton) and Washington, DC (I Street). 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.  Saylee Tulpule 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. Saylee Tulpule 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. Saylee Tulpule 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.