There is never a shortage of celebrity injuries on ABC's Dancing With the Stars.  This season, TV host Maria Menounos, is pushing through each routine despite suffering from a stress fracture in her foot.

Against medical advise, she continues to compete.  To prevent her condition from progressing, and developing into a true fracture, Maria has been immobilized in a removable cast boot and has been using a bone stimulator.

Bone typically takes 6-8 weeks to heal.  It is important for patients to remain non-weight bearing during this time to prevent the fracture pieces from shifting.  This can lead to delayed healing or healing of the bones in a less than ideal position.

If you or someone you know is suffering from foot swelling, pain and difficulty walking, it is important to be evaluated by a foot and ankle specialist.  Many patients walk around with undiagnosed stress fractures.

Please call 856-691-2152 to make a preferred appointment.

Most female patients are interested in knowing if it is safe to get a pedicure.  I have complied a list of pedicure tips that I hope you will find helpful. 

DO

• Choose a reputable salon
• Bring your own instrumentation
• Bring your own nail polish... the first question asked when entering a salon for a pedicure is "What color would you like?"  One doesn't know who chose that color before them and what state their nails were in

DON'T

• Shave your legs before getting a pedicure.  Freshly shaven legs or small cuts on the body can serve as portals for bacteria to enter the body.
• Allow salons to use a foot razor to remove dead skin.

For those of you who may be suffering from toe nail fungus, you should hold off on getting a pedicure until the infection resolves.  This may need to be treated with topical or oral antifungal medications.  I do not recommend using a regular nail polish on a fungal toenail.  Nail polish locks out moisture and doesn't let the nail bed "breathe."  Try the following polishes, which contain natural antifungal elements. 

http://www.remedynails.com/

https://www.deepcoversystems.com/

A large percentage of our practice is devoted to the diabetic foot.  Complications of diabetes, such as neuropathy and peripheral arterial disease, lead to ulceration and amputation.  The following website shows the impact of diabetes, ulcers and complications. 

If you or someone you know has diabetes, please take the time to explore the link below.

http://www.diabetesfootulcer.com/

It is recommended that adults participate in some form of physical activity for 30 minutes almost every day of the week.  Walking is a low impact, inexpensive and easy way to stay fit.  Walking can be an indoor or outdoor activity.

Benefits of walking include:

• Reduced risk of coronary artery disease.  Improved blood pressure, blood sugar levels and blood lipid profile
• Maintain body weight and lower the risk of obesity
• Reduced risk of osteoporosis
• Reduced risk of breast and colon cancer
• Reduced risk of Type II Diabetes
• Enhanced mental well-being

Invest in a good pair of walking or running sneakers.  Heel height should be between 1/4 and 1/2 inch.  If you are overweight, choose a shoe with a wider heel.  A wide toebox will allow free movement.  Always have shoe measurements standing up.  Fit the shoe from the longest toe to the heel.  The width should be measured at the ball of the foot near the widest part.

Recommended running shoes include: New Balance, Etonics, Saucony, Asics

For more tips on walking and appropriate shoegear, please visit www.apma.org

Ryan Howard was practicing in Clearwater, Florida without a boot on his left foot.

Howard had a procedure Feb. 27 to remove an infection around his Achilles tendon, which was surgically repaired in October of last year.  He was cleared to start light exercises without the boot last week.

Howard's return to the Phillies lineup is still uncertain.  Fans may have to deal with the possibility that he could miss the first two months.

Howard remains positive and will continue to do whatever it takes to make a full recovery before returning to first base.

thedailyjournal.com

Last week Woods had to back out of a tournament secondary to Left Achilles tendon pain.  This problem was the cause of two missed majors last year.  It was the second time in 10 months that Woods had to withdraw from a tournament because of his Achilles. 

Woods is scheduled to play the Arnold Palmer Invitational at Bay Hill, which starts March 22.

Achilles tendinitis is inflammation of the Achilles tendon, the band that starts out as the calf muscle and twists as it passes the behind the ankle joint and inserts into the back of the heel bone.

Pain and swelling is relieved by rest and sometimes immobilization in a removable cast boot.  Other treatment includes, ankle taping, ice, oral anti-inflammatory medications, and stretching. 

Please click on the link below for additional information and stretching exercises from the University of Illinois.

 http://www.mckinley.illinois.edu/handouts/achilles_tendinitis/achilles_tendinitis.html

With weather in the 70's this week, many are riffling through their closets to find their favorite pair of sandals.  In order to avoid "sandal scandal" this Spring, be sure to follow the American Podiatric Medical Association (APMA) tips below:

• Flats & Slides:  Most provide inadequate cushioning and support.  Avoid prolonged wearing and consider adding a cushioned insert for added support.  Select a sole that doesn't twist.
• Gladiator & Strappy Sandals: May cause irritation between toes and callus build up around the heel.  Lack support an shock absorption.  Select natural leather and be sure that toes and heel are not falling over thee edge of the sole. 
• Platform & High Heels: May cause pain in the ball of the foot and ankle injuries.  Wear heels less than 2 in. high
• Wedge & Espadrille Sandals: May cause ankle injury.  Try a wide, flat or stacked wedge with a rubber sole.
• Peep-toe Sandals: Excessive pressure on the toes and forefoot.  These may irritate Bunions, Hamertoes and Neuromas.  Wear only for short periods of time.
• Ankle Wrap Sandals: Lack of ankle support and friction which leads to blistering.  Try leather, cotton or silk straps.  Do not wrap straps to tight.

If you are experiencing persistent pain, please call 856-691-2152, for a preferred appointment with Dr. Markizon, Dr. Trang, Dr. Fassman or Dr. Tsombaris.

For more fun sandal and flip-flop facts please visit www.apma.org

New government research  shows a dramatic decline in the rate of foot and leg amputations in diabetic patients.  This is likely secondary to better treatments. 

The rate has fallen by more than half since the mid-1990s.  The Center for Disease Control reported in January 2012 that for older diabetics, amputations dropped from more than 11 to about 4 per 1,000 people.

Roughly 1 in 10 adults in the US is diabetic.  Diabetes is also the 7th leading cause of death among Americans.  Complications include poor circulation, nerve damage, slow healing wounds, infection and amputation.

In the CDC study, researchers checked national hospital discharge records for 1988-2008, looking for patients aged 40 and older who had lost a toe, foot or leg to diabetes.  They found that although the number of people with diabetes more than tripled over 2 decades, the rate of amputations after 1996 fell.

It's not clear what started the drop in amputation rate, but experts state that contributing factors include close monitoring, annual diabetic foot exams, an increase in patient education, Medicare coverage of blood sugar monitoring, protective shoes, and other medical devices.

To read more please click on the link below:

http://www.foxnews.com/health/2012/01/25/cdc-diabetes-amputations-falling-dramatically/#ixzz1kx58Rs8X

On Saturday, February 25th, Dr. Tsombaris and staff members Jessica and Lori participated in the South Jersey Healthcare Spirit of Women event - Day of Dance.  The event was held at the Cumberland County College.

Day of Dance is a community-based event, hosted by Spirit of Women hospitals across the country. This event offers fun for the entire family. Participants danced, learned simple ways to stay heart healthy, enjoyed music, and participated in health screenings.

Over 150 attendees were educated on common foot injuries/conditions, properly fitting shoes and foot care.  Over 50 attendees had their gait analyzed using our computerized Footmaxx system.

We had a lot of fun and are looking forward to participating next year!! 

Drs. Trang, Fassman and Tsombaris are wound specialists certified by the American Board of Wound Management. 

They use Negative Pressure Wound Therapy (NPWT) for hospital, office and Elmer Wound Care Centers patients.

Negative pressure (a vaccum), expedites wound healing by drawing the wound edges together, removing infectious material and promoting granulation tissue.

Wound V.A.C.^® (Vacuum Assisted Closure^®) is a type of NPWT which is indicated for patients with chronic, acute, traumatic, subacute and dehisced wounds, partial-thickness burns, ulcers (such as diabetic, pressure or venous insufficiency),flaps and grafts.

For more information, please visit the website below:

www.kci1.com

You read correctly... Fish Pedicure!

Several salons around the country are offering this service to patrons.  Fish pedicures have been popular in Asia, the Middle East and in the UK for years.

Clients dunk their feet into tanks with Garra rufa fish or "doctor fish."  These toothless carp are small  fish that nibble away dead skin.  Garra rufa are found naturally in the Middle East, Turkey, Syria, Iran and Iraq.

Fourteen states in the US, including Texas and Florida, banned their use over health and safety concerns.

The risk of infection associated with Garra rufa fish pedicures is likely to be very low, according to experts from the Health Protection Agency. In October 2011 it issued updated advice on fish spas following an investigation.

Fish tank water may contain a number of microorganisms. So there is the potential to catch a range of infections, either from fish to person, water to person or person to person passed on by the water or the fish.  However, the HPA says the overall risk of infection is likely to be very low, if the spa operates good standards of hygiene.

However, it advises people with weakened immune systems or underlying medical conditions, including diabetes and psoriasis, against using fish spas. It says people with these conditions are likely to be at an increased risk of infection. 

People with cuts or infections on their feet should allow them to heal before seeking treatment, and it is advised to wait at least 24 hours after having a leg wax or shaving.

Peripheral Arterial Disease (PAD) is a result of cholesterol and plaque build -up in the arteries of the legs and feet, causing decreased blood flow.

PAD testing is a non-invasive exam which assesses blood flow and blockages in the arteries.  Patients lie flat and a technician places blood pressure cuffs on the arms, thighs, calves, ankles, and toes.

PAD will be recommended by the doctor is there is suspicion for a narrowing or blockage of an artery. 

Symptoms of PAD include:  Diminished or absent pulses in the feet, pain in legs brought on by walking and relieved by rest, poorly healing wounds, rest pain, tingling/numbness in the legs, feet and toes, discoloration in the legs, feet and toes.

If you or someone you know is experiencing any of the above symptoms or has a history of diabetes, coronary artery disease, high blood pressure, high cholesterol or a history of tobacco use, please call Foot Care Centers at 856-691-2152 to make a preferred appointment.

I recently read an article about a new product created in Cleveland, Ohio.  "Nail creations" is a latex-free adhesive that can be trimmed, shaped and painted to cover up damaged toenails.

Often times patients are embarrassed by the way their toenails look.  The nail is thick, discolored and sometimes all together missing.  These nail changes may be due to a fungal infection or repetitive microtrauma.  Several of our patients who are runners end up loosing their toenails simply from the underside of the shoe rubbing on the nail plate.

If a patient is prescribed a medication by their doctor, this doesn't mean that that they have to stay at home with their feet covered.   "Nail creations" can be applied to one or all of the nails and will stay on for 1-2 days if a patient wants to wear sandals.  

For more information and pictures please visit the company website at www.appealingwhilehealing.com

If you enjoy watching CSI then you will certainly find this post particularly interesing.

Arthur Washburn, PhD., a professor at the Temple University School of Medicine, and Michael Sganga, a third year student at the Temple University School of Podiatric Medicine, are using feet to solve crimes.

Dr. Washburn, an anatomy professor at both the Medical and Podiatric Medical Schools has been consulting with the Philadelphia Medical Examiner's Office for about 20 years.

An individual's race, ethnicity and sex can be determined from a few key bones.   You may have not known that the sex of a person can be determined from the length of the heel bone.

In addition to bones. forensic podiatrists use foot print analysis, shoe wear patterns and gait patterns to rule in or rule out a suspect.

If you would like to find out more about forensic podiatry, please visit the American Society of Forensic Podiatry in Bandon, Oregon www.theasfp.org

On Wednesday January 18th, Dr. Tsombaris and staff member Lori , participated in the Petway Elementary School Career Day in Vineland, NJ. 

Dr. Tsombaris spoke to four third grade classrooms.  The students learned that a podiatrist is a doctor who specializes in foot and ankle medicine and surgery.  The children looked at pictures of common foot problems, casts, braces, orthotics, x rays and surgical instruments.

HAPPY NEW YEAR!

We are excited to announce that we have expanded office hours at our Elmer location.  For your convenience the office will be open the following days:

Monday  9am-5pm

Wednesday  9am-5pm

Thursday  1:30pm-4:30pm (evening appoinments up to 7pm will be available on alternating Thursdays)

Friday 9am-12pm

Please call to make your preferred appointment today!   856-358-8661

Foot Care Centers

340 Front Street, Suite 103

Elmer, NJ 08318

The Louis Garneau Carbon Pro Team shoes, designed for cycling, have Xylitol incorporated into the sole of the shoe. 

Xylitol gives gum and toothpaste a minty fresh sensation.  Because Xylitol is an alcohol-based sugar, it evaporates whenever it comes into contact with moisture. 

The shoe works by converting sweat to cool.  This a good option for athletes who are prone to sweaty feet from spending hours at a time in their athletic shoes.

Gout is a form of arthritis caused by too much uric acid in the bloodstream.  Uric acid travels to joints, most commonly the big toe, ankle, knee and fingers.  This causes the joint to become red, hot, swollen and extremely painful.

Treatment includes steroid injection and medications such as Colchicine, Indocin and oral steroids.  Gout attacks typically resolve within 48 hours of treatment.

If you experience multiple attacks within a limited amount of time, your doctor may place you on a "maintenance medication" such as Allopurinol or Probenecid to avoid future attacks.

"Eat, Drink and Be Merry" is a typical theme of the holiday season, but it is important to not overindulge, especially if you have a history of gout.  Foods high in purines should be avoided.  I have included a list below:

Happy Holidays! 

If you or someone you know may be suffering from gout please call Foot Care Centers at 856-691-2152 to make a preferred appointment.

I recently wrote a blog post on the use of Hyperbaric Oxygen Therapy (HBOT) and wound healing.   While watching an NFL game this past weekend, I heard the commentators mention that several professional football players have used hyperbaric chambers to heal faster from injury and return to the paying field quicker.

Most recently, Chicago Bears running back Matt Forte used HBOT for a sprained MCL in his right knee.  He also received an injection of platelet rich plasma.

HBOT became popular among NFL athletes in 2004 when then-Eagles receiver Terrell Owen used HBOT for a broken leg.

At Foot Care Centers, we offer the latest technology to our patients.  Patients suffering from foot and ankle pain will benefit from a custom orthotic.  Common causes of foot and ankle pain include plantar fasciitis, Achilles tendinitis, ankle sprains, neuroma and hallux limitus. Custom orthotics correct the patient's faulty foot mechanics, decrease pain and increase stability.

Footmaxx is a computerized gait and pressure analysis tool.  We can analyze the steps a patient takes and create an orthotic specific to their needs.

If you are an athlete or your feet tend to sweat and smell, we have a solution.  Footmaxx offers the Performaxx orthotic.  This device has a unique top cover which contains active particles that increase blood flow and oxygen, infused silver ions which capture and kill odor, and a dri-release which evaporates sweat quickly.

footmaxx.jpg

If you or someone you know would like more information on the Footmaxx system and custom orthotics, please call Foot Care Centers at 856-691-2152 to make a preferred appointment.

During the month of December, Foot Care Centers will be giving poinsettia plants to all of our patients at both our Vineland and Elmer locations.

Attached you will find a certificate inviting you or a friend to come in, meet our doctors and receive a Complimentary Consultation and Foot Examination.

Wishing you a Happy and Health Holiday!

Dr. Markizon, Dr. Trang, Dr. Fassman, Dr. Tsombaris

Joan, Susan, Charlien, Dawn, Miriam, Wendy, Jessica, Esther, Susan I, Christina, Michelle, Christina, Lori, Doreen and Linda

Philadelphia Eagles running back LeSean McCoy was resting a toe sprain early last week before the match up Thursday night with the Seattle Seahawks.  Fortunately this "toe sprain" was not turf toe.

Turf toe is a common injury amongst football and soccer players.  Turf toe is a sprain of the ligaments around the big toe joint.  This typically occurs on artificial turf, but can also happen on grass.

A hyper extension of the big toe joint causes pain, swelling and stiffness.  Treatment includes ice, rest compression, taping and wearing a stiff shoe which will prevent the toe from bending while it heals.

You may have heard  about Hyperbaric Oxygen Therapy (HBOT).  But what it is exactly and how do we use this in our podiatric practice?

During HBOT, a patient breathes 100% Oxygen at 2 to 3 times atmospheric pressure.  This increases the oxygen uptake in the blood.  The oxygenated blood is transported throughout the body to supply ischemic or diseased tissues. 

A patient generally undergoes 30-60 treatments.  Treatments must be on consecutive days (ie. Monday through Friday).

In our practice, we recommend HBOT for patients who are suffering from non-healing wounds, necrotizing soft tissue infections, bone infection and compromised skin grafts and flaps.

Other indications for HBOT include:

• Thermal burns
• Exceptional Anemia
• Decompression sickness & Air embolism
• Carbon monoxide poisoning
• Crush injury/compartment syndrome
• Delayed radiation injury

Contraindications include:

• Untreated Pneumothorax (collapsed lung)
• Pregnancy
• Congenital spherocytosis
• Certain medications: Bleomycin, Cisplatin, Disulfiram, Doxorubicin, Sulfamylon

Drs. Trang, Fassman and Tsombaris are Certified Wound Specialists affiliated with the Elmer Wound Care Center.

hyperbaricanswers.com

As written in a previous blog post, November is Diabetes Awareness Month.  The APMA (American Podiatric Medical Association) "Knock Your Socks Off" campaign is helping to raise diabetes awareness around the country.

Did you know that  66% of Hispanics are at an increased risk of developing diabetes?  This hits close to home as 27% of the population living in Cumberland County is Hispanic.

Diabetes is the number one cause of non-traumatic lower-limb amputations.  With proper foot care from a trained foot and ankle specialist (podiatrist) complications can be prevented.

In addition to being evaluated by your podiatrist, be sure to maintain tight control of your diabetes.  Some tips for better diabetic control include:

• Establish a customized plan with your family doctor and set goals
• Overcome barriers to exercise
• Make the correct food choices
• Check your blood sugar regularly and keep a log
• Maintain a healthy weight

If you or someone you know is suffering from diabetes please call Foot Care Centers at 856-691-2152 to make a preferred appointment.

Image from www.apma.org

Iraq War veteran J.R. Martinez is nursing his right ankle after sustaining a twisting injury during rehearsal on Saturday.  His Dancing with the Stars partner, Karina Smirnoff, stated that the injury took a toll on their subsequent rehearsals.

J.R., the frontrunner in the competition, struggled through his first dance, the Paso Doble, and ended up with a score of 23 out of 30.  He rebounded in the second dance, the Argentine Tango, with a score of 27 out of 30.

It is important to follow the the R.I.C.E. method after a sprain.  Rest. Ice. Compression. Elevation.

If you're still experiencing pain after implementing the R.I.C.E. method, it is important to be evaluated by a foot and ankle specialist.

British rocker Billy Idol was seen at a Beverly Hills medical center on Monday on crutches and with a cast on his right foot.

He underwent foot surgery on 11/2/2011 to "correct malformation of foot due to hitting a truck tire in road a year ago." 

Idol sustained a hair line fracture of one of the bones in his foot.  

Bone healing occurs by developing bone callus at the fracture site.  If the bones are in good alignment and the patient is immobilized in a walking boot or cast, healing will take about 6-8 weeks.  Healing can take longer if the bones shift or if the patient walks to soon.   Surgery is sometimes indicated to realign the bones or correct bones that have healed in a less than ideal position.

rocktrezor.blogspot.com

Over the summer Congresswoman Michele Bachmann made a correlation between migraine headaches and wearing high-heeled shoes.  Her son, Dr. Lucas Bachmann, a medical resident at the University of Connecticut, confirmed that his mother in fact noticed a connection between days she wears heels and the onset of migraines.

Medical experts commented and the general consensus was that a direct link between the two is unlikely.

Running a presidential campaign is certainly stressful and a possible source of migraines.  Also, if she suffers from neck and back pain, this could be exacerbated by wearing high heels.

Typical side effects of wearing high-heeled shoes include bunion and hammertoe deformities, and nerve entrapment in the ball of the foot called Neuroma.

Fall is officially here!  A comfortable, stylish boot is the perfect accessory for the season.  Follow these simple tips and your feet will thank you.

• Choose a boot made from natural materials such as leather.  Leather expands and contracts depending on the temperature.  It allows for air flow and will keep your feet dry.  Synthetic materials are less forgiving.  They lead to an increase incidence of blisters.  They don't allow your feet to breath, which causes increased sweating and potential for fungal infections such as Athlete's foot.  ** Look on the inside of the boot:  the "upper material" should be stamped on the inside **
• Choose a round or square toebox.  Be sure to leave room for your toes!  Most riding, rain, and snow boots come with a rounded toe.  Dress boots come with a variety of toeboxes (pointed/narrow, round, square).  Avoid Cowboy boots which are narrow through the front and can crowd toes and cause blisters.
• Choose your heel wisely.  Avoid heels over 2 inches high.  Any higher will shift the weight to the ball of the foot which will cause pain, tingling and numbness. A stacked heel or wedge helps alleviate pressure through the front of the foot.
• Choose a boot that fits an arch support.  Whether you prefer a dress or casual style, most boots will accommodate an insert.  I do not recommend wearing an UGG boot without an insert.  Bring the insert with you when trying on boots.

Some other general tips include having your feet measured and always buying for the larger foot.  There is no such thing as a "break-in" period, so if the shoe or boot is not comfortable immediately move on to the next pair. 

Happy shopping!

Diabetes is quickly becoming an epidemic in this country.  There are 26 million American children and adults living with the disease and another 79 million at risk.

The following statistics were obtained from the American Diabetes Association website www.diabetes.org.

• Every 17 seconds, someone is diagnosed with diabetes
• Diabetes kills more people each year than breast cancer and AIDS combined
• Recent estimates project that as many as 1 in 3 American adults will have diabetes in 2050 unless we take steps to Stop Diabetes www.stopdiabetes.com

Diabetes affects the body in many ways.  Uncontrolled glucose levels lead to poor eye site, poor kidney function, poor circulation and nerve damage (peripheral neuropathy).  Neuropathy is the #1 risk factor for developing a diabetic ulcer.  If not treated in a timely manner, this may lead to complications, including amputation.

If you suffer from diabetes, be sure to maintain tight glycemic control, inspect your feet daily, dry well in between your toes and avoid barefoot.

Please call 856-691-2152 to make a preferred appointment.  A comprehensive diabetic exam will be performed by one of our foot and ankle specialists.

Staff members Jessica Lore and Michelle Acosta represented Foot Care Centers at The Bone Run & Walk held at Parvin State Park in Pittsgrove, NJ on Saturday October 29, 2011.

Over 300 runners participated in the event.  Samples of Biofreeze were given.  Properly fitting shoe tips were distributed.  Common running injuries including heel pain, tendonitis, shin splints, blisters and ingrown toenails were discussed. 

Jessica and Michelle also recommended Powerstep inserts (arch supports) and Spenco heel lifts (which are made of compressed nitrogen bubbles and absorb shock) to participants.

Funds raised from The Bone Run & Walk help support South Jersey Healthcare in fighting America's number-one bone disease: Osteoporosis. The event featured food, music and complimentary screenings at the health fair.

This past Thursday, October 27, 2011, Foot Care Centers participated in the Cumberland Dairy Health Fair in Bridgeton, NJ.

Staff members Jessica Lore and Lori Smith spent the day with over 50 employees and their spouses.  Over 30 participants had gait analysis performed using our state-of-the-art Footmaxx system.  Patient information was given on heel pain, fungal toenails, Athlete's foot, bunions and custom arch supports.

For more information on Cumberland Dairy, visit their website www.cumberlanddairy.com

As podiatrists, we are frequently asked the question above.  The answer is not always cut and dry.  I have included several of the most common causes of burning and numbness in the list below:

• Poor circulation or Peripheral Arterial Disease (PAD)
• Back Problems - Degenerative Disc Disease or Sciatica
• Peripheral Neuropathy
• Diabetes Mellitus
• Localized nerve entrapment
• Inflammatory conditions

It is imperative to speak with a medical professional if you are experiencing pins and needles, burning, tingling or numbness, as this may be a sign of underlying disease.

Please call Foot Care Centers as 856-691-2152 to make a preferred appointment.

HAPPY HALLOWEEN from all of us at Foot Care Centers!!

Do you or someone you know suffer from sweaty, smelly feet?  Well we have just the treat... Bromi-Lotion.  This convenience item, available at Foot Care Centers, is unique among antiperspirants in that it is formulated as a soothing lotion, rather than as a spray or roll-on.

Fungus and warts thrive in moist environments.  A sweaty foot in a sock and shoe is a perfect setting for nail fungus, althete's foot and viral infections to thrive.

Try Mycomist in combination with Bromi-Lotion.  

Mycomist spray is a disinfectant specially formulated to kill odor causing germs.  Simply spray your shoes and/or boots with Mycomist and enlcose in plastic bag for 24 hours.  For best results use spray 2-3 times per week and alternate shoes.

By participating in Back on My Feet Sneaker Week, you will be helping to raise $1 million, which will be used to help 500 men and women experiencing homelessness.

By making a $5 donation to Back on My Feet, employees of participating companies, organizations and schools will be wearing their sneakers to work the week of November 14-18.  If you or your employer are interested in participating you may sign up at http://www.backonmyfeet.org/sneaker-week.html

Back on My Feet ( http://www.backonmyfeet.org/ ) is a "national nonprofit organization that promotes the self-sufficiency of people experiencing homelessness by engaging them in running as a means to build confidence, strength and self-esteem."

On Saturday, October 22nd, Dr. Markizon, Dr. Trang, Dr. Tsombaris and 15 staff members attended the Sterling Practice Management Seminar in Philadelphia.

Topics discussed included public relations, marketing, problem solving, communication and leadership skills. 

Our goal as a practice is to work as a cohesive team, educate our patients and provide the best comprehensive care possible. 

Since staring on ABC's Dancing with the Stars, Chaz Bono has been dealing with ankle and knee pain.   Most of the "stars" competing have little to no dance experience.  Dancing places unusual stress on the body, especially your feet.  Instability at the foot leads to ankle, knee, hip and back pain.  Cher had her own personal podiatrist evaluate and treat her son Chaz.

Common foot problems associated with dancing include hallux limitus (limited range of motion/jamming of the great to joint),metatarsalgia (inflammation of the ball of the foot), plantar fasciitis (inflammation of the band on the bottom of the foot that supports the arch), and stress fracture (hair-line bone break caused by repetitive micro trauma).

If you are suffering from foot or ankle pain related to dancing, don't delay in having this evaluated.  Pain is not normal, and more often than not, will not "go away on it's own."  Dancing on an injured foot and lead to further pain and damage. 

A trained foot and ankle specialist will review x ray findings, perform cortisone injection if necessary to reduce pain, review stretching, shoes and the benefits of arch supports. 

Does your foot look like the picture above?  Do you have a knot at the bottom of your big toe that seems to be growing?

A bunion is an irregular enlargement of the bone at the base of the great toe.  This causes the great toe to move in the opposite direction toward the lesser toes.  Bunions are progressive, meaning that they can become worse over time.  Women are more affected than men.

Bunions are caused by wearing ill-fitting shoes, flat feet, congenital deformities (abnormal formation of foot bones present at birth), rheumatoid arthritis, trauma and inherited factors.

Conservative (non-surgical) treatment includes a shoe with a wide deep toe box, padding and arch supports.  If the joint becomes inflamed (red, hot, swollen) this is treated with cortisone injection.

For those with persistent pain, surgery is indicated.  This involves removing the bump and realigning the toe.  The goals of surgery are to reduce the deformity, decrease pain and increase function.  Recurrence may occur after surgery, therefore it is important to wear proper shoe gear to reduce the chances of surgical failure.

If you or someone you know is concerned that they may have a bunion, call Foot Care Centers at 856-691-2152 to make a preferred appointment.

Phillies fans are not only dealing with the devastating loss to the Cardinals in game 5 of the NLDS this past Friday,  but they are now left with the uncertain future of power-house player Ryan Howard who was injured on the final at-bat. 

"I was trying to run and I felt this pop and the whole thing went numb, like it was on fire," he said.  "it literally felt like I had a flat tire.  I tried to get up and I just couldn't go."

MRI has confirmed that Howard ruptured his Achilles tendon.  Surgery is planned to repair the tendon once the swelling subsides.  Recovery from an injury such as this can take 6-9 months, and in some instances can be career ending.  The next big question will be if Howard can make it to Spring training.  Only time will tell.

A 29 yo California man is the fist person in Kern County to receive a bionic foot.  The Proprio Foot is an artifically intelligent and motor-powered prosthesis.

This prosthesis virtually eliminates limping, compensating, reduces fear of tripping and reduces pain associated with the physical demand placed on the knee, hip and back.

Other models are rigid and have a fixed ankle.  The bionic foot senses motion and is able to adapt to different ground surfaces.

Amputation can result from complications of diabetes, peripheral arterial disease (PAD), traumatic injury and congenital defects.

The bionic foot may be useful for military professionals returning from overseas who have suffered traumatic amputations.

Steelers quarterback Ben Roethlisberger injured his left foot during the 4th quarter of Sunday's game against the Houston Texans.  He finished out the game, but limped off the field and was seen using crutches and wearing a walking boot as he left the stadium.  X rays were taken, followed by an MRI which showed that the foot was not broken.

Roethlisberger sustained a broken bone to the right foot last year and managed to play through the 2nd half of the 2010 season.

One may hear an audible "crack" or "pop" during an injury, followed by swelling, pain and bruising.  Use the "RICE: Rest, Ice, Compression, Elevation" method following any traumatic injury, and be sure to follow up with your foot and ankle specialist.  You will likely need x rays to rule out fracture.  In some cases braces and walking boots may be necessary to properly immobilize your foot. 

Halle Berry is on location in Spain shooting her new movie "Cloud Atlas."  A little over a week ago, Halle was on the property where she is staying and took a misstep.  She heard a noise and subsequently developed pain.  After evaluation at a local hospital, she was treated for a broken bone in her foot, and was place in a cast.

Broken bones are sometimes treated with cast immobilization alone.  Bone takes about 6-8 weeks to heal.  In some cases, surgical intervention is required.  Screws and plates are used to realign the bone, which speeds up the healing process.

Foot Care Centers' doctors are trained in fracture care and management.  If you or someone you know has sustained an injury and are afraid you may have broken a bone, do not hesitate to call 856-691-2152 to make a preferred appointment.

Matt Stutzman, a man is his late twenties from Fairfield, Iowa, was born without arms.  He doesn't see this as a disability, but an opportunity to live life to the fullest.  He is a husband, father of two and an archer.  Not only does he shoot a bow and arrow with his feet, but he eats, drives, and rides a motorcylce.

He  has qualified for the National US Olympic Team in Archery (not Paralymic), and attended the Olympic Trials in Italy this July.  His ultimate goal is the win a gold medal at the 2012 summer games in London.

Check out the link below to see this amazing and inspirational athlete:

http://mix108.com/inspirational-archer-without-arms-aims-for-olympics/

This past Saturday, Foot Care Centers participated inthe South Jersey Healthcare Women's Health Education Day.  The event was held at South Jersey Healthcare Regional Medical Center in Vineland. 

Dr. Tsombaris and staff member Jessica Lore interacted with over 100 attendees and performed gait analysis on over 50 patients.  Topics discussed included diabetic foot care/wound care, neuroma, bunions, flat feet and dry, itchy skin.  We reviewed properly fitting shoes and inserts.  Samples were given for sweaty, smelly feet and dry, cracked heels.

One lucky participant from Woodstown won a beautiful basket filled with a pair of Dr. Comfort slippers, Dt. Comfort socks, creams, powder and few other goodies.

We're looking foward to our next Health Fair at the Cumberland Dairy October 27, 2011.

Dr. Tsombaris attended the Podiatry Institute Conference in Atlantic City, NJ this weekend.  This 3 day conference focused on forefoot surgery and the complicated foot. 

Platelet Rich Plasma therapy for the treatment of tendinitis was discussed.  Foot Care Centers has been offering this treatment to patients for over 5 years.  To date, there are a limited number of scientific studies published on this topic.  Dr. Tsombaris will be collecting past and current patient data, with the goal of publishing a study detailing outcomes of using Platelet Rich Plasma in the foot and ankle.

Foot Care Centers participated in the Gerresheimer Glass, Inc. Health Fair in Vineland, NJ on Thursday, September 15th. 

Dr.Fassman, along with staff members Jessica Lore and Dawn Sharp, interacted with over 250 employees.  Gait analysis was performed using our state of the art Footmaxx system.  This identifies foot type and areas of increased plantar pressure.

Patient information, samples and raffle prizes were also given.

Look for Foot Care Centers at the upcoming South Jersey Healthcare Women's Health Screening and Education Day on Saturday September 24, 2011 from 9:00 am to 1:00 pm at SJH Regional Medical Center 1505 West Sherman Avenue Vineland, NJ 08360.  For more information call 888-SJH-WOMAN.

Barefoot running has exploded over the last year.  The theory behind this trend is that an unrestricted foot leads to strengthening of small muscles, increased flexibility and prevention of injury. 

Most podiatrists cringe at the thought of barefoot running, as this may lead to trauma (ie. stepping on broken glass, gravel and other debris), stress fractures and tendon/ligament injury.

If you are considering running barefoot or in a minimalist shoe, you MUST start slowly.  An abrupt transition is sure to cause injury. 

Minimalist shoes to cosider include Vibram Five Fingers, Merrell, Saucony and Brooks.

You may also want to read the book Born to Run: A Hidden Tribe, Superathletes, and the Greatest Race the World Has Never Seen by Christopher McDougall.

Do you have pain in your legs at rest or when walking?  You may be suffering from PAD (Peripheral Arterial Disease).

Other symptoms include:

The above symptoms can lead to poor wound healing, gangrene and put you at risk for heart attack or stroke.

Don't delay in having this evaluated.  Specific testing can be done to diagnosethe severity of your disease.  Treatment options include life style change, medication and surgery.

Celebrities like Victoria Beckham, Rachel Zoe, Kate Hudson and Alicia Keys won't give up their stilettos, even during pregnancy.  These pregnant fashionistas have been photographed in heels as high as 5 inches!  Victoria Beckham reportedly suffered a slipped disc in her back as a result of wearing sky-high heels.

A woman's body changes in shape and size during pregnancy.  Curvature of the spine leads to low back pain, as well as a loss of center of gravity, which can lead to falls.  This can be exacerbated by wearing high heels.

Flats and small heels (less than 2 inches) are ideal.  The bottom line is listen to your body and wear what is comfortable. 

Researchers in several small Tanzanian villages are using smelly socks as a means to lure mosquitoes.  Malaria infected mosquitoes account for 900,000 deaths per year, most of them being children.

Smelly socks attracted 4 times as many mosquitoes than the human flesh.   The socks, in conjunction with insecticide-treated bed nets, could be a huge breakthrough in preventing malaria and saving lives.

If you have sweaty, smelly feet and want to prevent becoming a mosquito magnet, try Bromi-Lotion.  This convenience item, available at Foot Care Centers, is unique among antiperspirants in that it is formulated as a soothing lotion, rather than as a spray or roll-on.

With the recent end of the N.F.L. lockout, players jumped right back into training camp, many without having completed supervised workouts during the off-season.   This has lead to a considerable rise in injuries. 

There have been reports of at least 10 players with Achilles' tendon tears.  This is a season-ending injury for most.

Sports medicine specialists believe that the number of injuries will taper off as the season continues, and as players achieve improved physical fitness and strength.

For those "weekend warriors" out there, be sure to stretch properly prior to any physical activity (tennis, basketball, softball, flag football or running). 

Simple Achilles stretch:  Place the balls of your feet on the steps leaving your ankles hanging of the steps. Holding onto a railing or putting your hand on a wall as a guide, allow your weight to drop your heels below the level of the stairs.  Hold for 20 seconds. Then slowly raise yourself back up. Repeat this exercise 10 times.  Repeat 3 times a day.

If you or someone you know is suffering from Achilles pain or may have injured the Achilles tendon, please call 856-691-2152 to make a preferred appointment.

Your kids may be ready for the start of a new school year, but are their feet?  Labor Day is fast approaching and school children all over the country will be making the transition from Crocs, sandals and flip-flops to sneakers, boots and dress shoes.

A new pair of shoes is one of the most important items on any back-to-school list.

When shopping for shoes, keep the following in mind:

• Measure your child's feet, as shoe size may change every few months.
• Look for natural materials such as leather, this will expand and contract, cause less irritation/friction and allow the foot to breath.
• Never hand down shoes.  Shoes fit each individual differently.  You can also prevent spread of fungal infections such as athlete's foot.
• Check the heel for wear.  If this is uneven, your child may have a foot problem and will need to be evaluated by a podiatrist.
• Always buy for the larger foot.
• There is no such thing as a "break-in" period.  Shoes should be comfortable from the start.
• Bring socks when trying on shoes.

Let the shopping begin!!

Two of the most common foot problems diabetics face are Neuropathy and Peripheral Arterial Disease.

Diabetic neuropathy, or nerve damage, is a result of uncontrolled diabetes.  Damaged nerves cause symptoms like burning, tingling and numbness.  If you have a lack of feeling in your feet you are more likely to develop a cut or sore.  The muscles in the feet maynot function well, as they are controlled by nerves.  This causes and shift in alignment and may create too much pressure in one area.

Peripheral Arterial Disease, or poor circulation can be caused by diabetes.  Without adequate blood flow, cuts and sores take longer to heal.  The longer a sore stays open, the greater the chance of infection with complications including gangrene and amputation.

10% OF PEOPLE WITH DIABETES WILL DEVELOP FOOT ULCERS

***If you have diabetes be sure to look at your feet daily and never walk barefoot!

If you have a history of diabetes please call Foot Care Centers at 856-691-2152 to make a preferred appointment.

While chasing a burglar in his San Fransisco hotel this early this morning, Alex Trebek ruptured his Achilles tendon.

The Achilles tendon connects the calf muscle to the heel bone.  When the calf muscle contracts the tendon pushes the foot downward.

Causes of injury include overuse, trauma, poorly fitting shoes, and certain medications. 

In some cases the patient may be immobilized after rupture, but the best results as far as healing and decreasing the chance of re-rupture are with surgical repair.  Mr. Trebek is scheduled for surgery this Friday.

Do you have areas of thick skin on the bottom of your feet or tops of your toes?  Does this cause pain with walking or pressure from shoes?  Have you tried over-the-counter corn/callus preparations without relief?

If you answered YES to the above, you may be suffering from corns and calluses.  Thickened skin develops in areas where there is increased pressure, for example the ball of the foot or on the top of the toe joints.  The body tries to protect itself by laying down extra skin, but over time the build up can be very painful and even cause difficulty with walking.

At Foot Care Centers, we will perform and thorough exam and explain to the patient WHY they are developing these lesions.  The painful areas will be removed and padding applied to reduce pressure.  Recommendations will also be made for properly fitting shoes.

If you or someone you know is suffering from painful corns and calluses please call 856-691-2152 to make a preferred appointment.

Do you experience a sharp pain in your heel when you step out of be in the morning?  If so, don't delay in having this treated! 

You may be suffering from plantar fasciitis, inflammation of the band that supports your arch.  In most cases, heel pain will resolve with conservative treatment.  This includes oral and injectable anti inflammatory medicines, stretching, icing and heel/arch supports.

Roughly 10% of patients continue to suffer from heel pain despite conservative treatment.  Foot Care Centers offers advanced therapies including Extracorporeal Shock Wave Therapy (ESWT) and Autologous Platelet Concentrate (APC +).

ESWT and APC + are both noninvasive, outpatient procedures.  ESWT heals by directing high-energy sound waves to the painful area.   APC + uses the patients own platelets which are injected into the injured site.  Platelets are rich in growth factors which jump start healing.

 If you or someone you know is suffering from heel pain please call 856-691-2152 to make a preferred appointment.

Ingrowing nails are one of the most common problems treated by podiatrists. 

An ingrown toenail is the result of the nail growing or curving into the skin around the nail.  This can be hereditary, a result of wearing tight fitting shoes, cutting the nails too short or trauma. 

Many patients attempt "bathroom surgery" at home, however this can lead to further pain and even infection.  The most effective treatment is removing the entire side of the nail.  This can be "temporary" where the side of the nail grows back or "permanent" where a chemical is used to kill the nail root to prevent the side of the nail from re-growing.  This treatment should only be rendered by a trained podiatrist.

If you  or someone you know is suffering from ingrown toenails do not hesitate to make a preferred appointment by calling 856-691-2152.

Nicole "Snooki" Polizzi of MTV's Jersey Shore will be launching a line of flip-flops due out this fall.  If you want to look good , but be pain free this summer simply follow the tips below.

When shopping for flip-flops be sure to choose a pair made from natural materials.  Leather expands and contracts and is less likely to cause friction which can lead to blisters.  Inspect the base of the flop, making sure that it has a built in arch support.  Bend the front of the flip-flop, it should bend  where the toes bend naturally, not in the middle of the sole.  Also, be sure to wear the appropriate size.  Your toes and/or heel should not be haning over the edge.

Avoid wearing flip-flops while playing sports, doing yard work, or while walking and standing for extended periods of time.

Brands to look for include Fit Flop Limited, Chaco, Birkenstock, Dansko, SOLE, Reef and Rainbow.

Dr. Jacob Fassman attended a great meeting this week on Epidermal Nerve Fiber Biopsy.  This technique allows your podiatrist to quantify the amount of nerve damage that may be induced by conditions
such as Diabetes Mellitus with Neuropathy.  This technique can be helpful
in guiding a patients treatment to decrease foot and ankle pain. 

 
By a small, 3mm punch biopsy on the ankle, we can now definitively tell
what type and how much nerve injury a patients has sustained
and formulate  a comprehensive treatment plan to help their pain.

If you are experiencing burning, tingling or numbness in your legs or feet, please call 856-691-2152 for a preferred appointment.

Did you know that one out of three adults age 65 and older falls each year?  Falls can lead to decreased mobility which can increase the risk of falling again, injury and even death.  Our goal at Foot Care Centers is to provide our patients with a comprehensive exam.  We will determine the reason why you are falling and recommend the appropriate treatment plan according to your needs, giving you a better quality of life!

If you have a history of falls or are afraid of falling, please call Foot Care Centers to make a preferred appointment at 856-691-2152.

I was treating a patient the other day and the first question she had when I walked through the door was "What is Plantar Fasciitis?"  She mentioned that while watching an episode of the Deadliest Catch on the Discovery Cannel, one of the veteran crew members couldn't pull his weight on the ship because of heel pain.  Plantar fasciitis is one of the most common causes of heel pain and can be quite debilitating. 

The plantar fascia is a band of connective tissue which supports the arch.  It originates at the base of the heel and inserts into the ball of the foot.  Inflammation of the plantar fascia can be triggered by a change in activity, change in shoes, faulty foot mechanics, weight gain or trauma.  Pain typically occurs with weight-bearing after long periods of rest, most commonly with first steps out of bed in the morning.  Plantar fasciitis responds well to anti-inflammatory medications, stretching and appropriate arch support. 

If you are experiencing heel pain, please call Foot Care Centers for a preferred appointment at 856-691-2152.

Foot Care Centers of Vineland, NJ, along with several other health care providers and organizations, was invited to the 2nd Annual Petway Elementary School Health fair.  The event was held on June 1, 2011, and was designed to promote healthy living.  Over 200 students, parents and faculty were in attendance.
 

Caption:  Dr. Diana Tsombaris (right), a member of the American Academy of Podiatric Practice Management, reviews a gait analysis scan with the physical education director (left) and the Petway Elementary Principal (center).

Dr. Diana Tsombaris and Dr. Ronald Markizon answered questions about athlete's foot, warts, flat feet and various foot deformities.  Properly fitting shoe and orthotic recommendations were also given.

 

Go to the www.crocsrx.com website.  Go to the patient's link and shop using the Foot Care Centers referral code 4011738 and receive 20% off of your purchase!

Our doctors are available to evaluate you and your foot care needs and would be happy to recommend a style.

For questions or more information on the Crocs Rx program please call Foot Care Centers at 856-691-2152.