Dr. Colon

Halle Berry Fractures Foot!

2011-09-22T09:43:00.000-07:00

Have you heard the latest Halle Berry news? She fractured her foot in Spain today while filming her new movie. But don't worry! She'll be fine. She was taken to a local hospital where her foot was placed into a cast, and she left in a wheelchair.

Most likely, she'll be back to normal in 6-8 weeks. That is the usual amount of time it takes for bone to heal, assuming there are no complications. And believe it or not, she will be able to get around with a cast on her foot. She may need crutches though, depending on the type of cast that was used. But the wheelchair won't be necessary after today.

More information on Fractures:
Broken bones in the foot are often painful, but rarely disabling. Fractures of the foot usually heal without surgery if treated properly.

There are 2 types of foot fractures: stress fractures and broken bones (general fractures).

Stress fractures are not complete fractures but more like cracks on the bone surface or partial bone fractures. They can occur with sudden changes in activity level, such as training for a marathon or military training programs (that is why they are also called "march" fractures.

Bone fractures extend through the bone and are more complicated to treat if there are complications such as displacement, multiple fracture fragments, crushed fragments, in an open wound, etc. They are usually caused by trauma.

Common symptoms include pain, swelling, bruising, limping, and inability to bear weight on the injured foot. If you suspect a fracture, see your podiatrist immediately for x-rays and proper treatment.

Michele S. Colon, DPM
3503 Lexington Ave.
El Monte, CA 91731
(626) 442-1223

dr.michele.colon@gmail.com

www.elmontefootdoctor.com

Miranda Cosgrove Suffers Broken Ankle

2011-08-16T18:10:00.000-07:00

Much to my 9 year old daughter's surprise and concern, Miranda Cosgrove, the teen star of Nickelodeon's "iCarly," suffered a broken ankle when her tour bus crashed into a tractor-trailer in Illinois earlier this week. Apparently, the tractor-trailer was already overturned when the tour bus hit a portion of the vehicle that was blocking one of the lanes. Although there was a total of five passengers on the tour bus, everyone will be okay. Cosgrove seems to have the most serious injury of everyone involved. She had been performing in Ohio on Wednesday night and was traveling to Kansas where she was scheduled to perform on Friday. Her "Dancing Crazy Tour" is now postponed until further notice...

A little bit of info about Ankle Fractures:

Doctors have noticed an increase in the number and severity of broken ankles since the 1970s.

The ankle has two joints, one on top of the other, and three bones. A broken ankle can involve one or more of the bones, as well as injury to the surrounding connecting tissues or ligaments.

There are a wide variety of causes for broken ankles, most commonly a fall, an automobile accident, or sports-related trauma.

Because a severe sprain can often mask the symptoms of a broken ankle, every ankle injury should be examined by a physician. Symptoms of a broken ankle include:
Bruising.
Swelling.
Immediate and severe pain.
Inability to put any weight on the injured foot.
Tenderness to the touch.
Deformity, particularly if there is a dislocation or a fracture.

The treatment for a broken ankle usually involves a leg cast or brace if the fracture is stable. If the ligaments are also torn, or if the fracture created a loose fragment of bone that could irritate the joint, surgery may be required to secure the bones in place so they will heal properly.

Dr. Michele Summers Colon, DPM, MS

3503 Lexington Ave.

El Monte, CA 91731

(626) 442-1223

http://www.elmontefootdoctor.com/

Why The 'Black Swan' Needs a Podiatrist!

2010-12-19T14:06:00.000-08:00

Have you seen the Black Swan movie yet? She really needs a podiatrist!

Don't worry...I'm not going to ruin the movie for anyone but the Black Swan dancers really need a podiatrist! I was surprised at how much screen time was given to their feet with close-ups of foot injuries, stretching, warm-ups, and the dancers' foot deformities. Here's a little recap of what I'm talking about:

Injuries:

1. Lacerated nail bed: While spinning on pointe, the main dancer injures her toenail of her big toe, leaving it cracked vertically and bleeding. Most likely it would need to be removed, cleansed, and possibly treated with antibiotics for infection control/prevention.

2. Sprained ankle: Dancers and many other athletes (especially basketball players) fall and twist their ankles, leading to ankle sprains or even foot or ankle fractures. The key to this injury (if there are no fractures) is early treatment such as the 'RICE' treatment which consists of rest, ice, compression wrapping, and elevation of the injured foot.

3. Achilles tendonitis: A pain in the back of the heel area where the Achilles tendon attaches to the heel bone, especially when there is a bump in the tender area along the tendon, is probably Achilles tendonitis (inflammation of the Achilles tendon) or a partial tear of the Achilles tendon (With a complete rupture of the Achilles tendon, the patient would not be able to walk.) Early treatment is also important with these injuries to prevent a partial tear or inflammation of the tendon from becoming a complete rupture.

Stretching & Warm-ups:

1. Heel cord stretching: Dancer's heel (plantar fascitis) is a common occurrence when the heel cord tightens so heel cord stretching and warm-ups are essential for injury prevention.

2. Physical therapy: In the movie, the trainer is shown giving adjustments to the dancer to correct for tight diaphragm muscles and tight ankle joints. When adjusting the ankle, you can hear an audible click which sounds painful but really just feels like a release (like when you crack your own knuckles or your neck).

Foot Deformities:

1. Hammertoes: With the use of classical ballet pointe shoes, the toes are put through tremendous forces supporting the body and for this reason most dancers do not begin to dance en pointe until after age 12. Even that is not enough to prevent deformities such as hammertoes, bunions, and bunionetttes (Tailors bunion).

2. Syndactyly: This is not a dance deformity, but it was shown in the movie. Syndactyly is the fusion of two or more toes. In the movie, the first and second toes are fused together as one extra wide toe, and the fourth and fifth toes are also fused together in one scene. In reality, these are congenital defects that can be corrected with surgery.

Of course, there are many other "dancers' injuries," "dancers' warm-ups" and "dancers' foot deformites" to discuss such as sesamoiditis, corns and calluses, blisters, bursitits, but these are the ones shown in 'Black Swan.'

For other foot and ankle questions regarding dancers or dance, please contact my office directly.

Dedicated to your foot and ankle health,
Dr. Michele Colon, DPM, MS

3503 Lexington Ave, El Monte, CA 91731 (626) 442-1223

dr.michele.colon@gmail.com

The Shoe Expert
“All Shoes, All the Time!”

Podiatric Patient Testimonials for November

2010-12-02T11:21:00.000-08:00

As November, or American Diabetes Month as we call it in our office, ends we would like to share some of our November patient testimonials with you. These patients came to our office with a variety of podiatry issues such as ganglin cyts, fungal toenails (onychomycosis), foot ulcers (diabetic foot wounds), pain in the ball area of the foot (metatarsalgia) and more.

"Since the first time I came to see Dr. Colon in 2002, I've been treated well here. Everything is perfect now with my toe. Your office has treated me stupendously. I have sent many members of my family here because the doctor and all of the staff treat me well. I'm very grateful." -- S. A.

"I'm doing much better since my first visit here because I needed my toenail fixed, and I still like coming here. I felt much better immediately after beginning the treatment. Thank you, Dr. Colon. I have confidence in you and am grateful for the attention you gave me. Thank you again for your pleasant and efficient service." -- A. T.

"I came here for the first time to have the bump on my foot checked, and bump got smaller after the medication. The service is good. I would refer a friend or family member because of the service." -- A.B.

"Dr. Colon is an excellent podiatrist. She is an assett to the Hispanic community. Her philosophy is to educate the patient so they are not only feeling better, but will not make the same mistakes in the future. I highly recommend Dr Colon." -- A.M.

"Easily one of the nicest and most responsive doctors I know. She will take the time you need and discuss what is right for you. Great bedside manner. I completely recommend her." -- J.L.

This last one is not actually from November. It is a series of messages from earlier this year from one of my marathon running patients, but I wanted to include them anyway. :)

March 2010: "Thank you, doc. I ran a PR (personal record) this weekend. Foot felt good until mile 20. We're almost there. Such a different experience. You give me hope. Thank you." -- P.G. May 2010: "I tried the new orthotics out. I ran the Palos Verdes half marathon. All-time PR for a half. You're the BEST." -- P.G.
September 2010: "I ran Mount Baldy trail race. I beat last year's time by 20 minutes and set a new PR, thanks to you." -- P.G.

And now I would like to say "Thank you" to all of my patients who spent their time to fill out an office survey or to write a recommendation for me, my office, and my staff. I appreciate it very much!

Please check out my new website! http://www.elmontefootdoctor.com/

Dr. Michele Summers Colon, DPM
3503 Lexington Avenue, El Monte, CA 91731
(626) 442-1223
dr.michele.colon@gmail.com

What Would Your FEET Tell Your Teen Self? (part 2)

2010-05-26T23:47:00.000-07:00

When it comes to foot health, some things are pretty basic but we might not think of them as teens or young adults. Many patients say "If I would have only known..." or "If I could go back in time..." referring to shoe choices or other foot care issues. So to continue this discussion, here are the rest of my Top 10 thoughts on this issue (part 2):

6. “Don’t assume that a rash, an infection, or foot odor will go away on its own.” Most of these conditions require a simple medication, but just waiting does not cure them. Some can be treated with over the counter products, but others require a prescription from a doctor.

7. “Don’t buy cheap shoes.” You get what you pay for when it comes to shoes! A $10 pair of shoes does not feel or function the same way a $50 pair of shoes does. This is especially important for children, teens, athletes, diabetics, and anyone else who spends hours on their feet every day…so pretty much almost everyone! A good pair of shoes costs more but will also last longer too, so buying those really cheap shoes don’t really save you that much money in the long run.

8. “Don’t get pedicures at nail salons unless you are sure they are sanitary.” Do your research and make sure they are using the proper solutions to sanitize their instruments. Or bring your own nail clippers and nail files with you. The last thing you want to do is catch a nail fungus or a foot infection from getting a pedicure. And as a podiatrist, let me tell you…it happens all the time!

9. “Don’t try to remove an ingrown toenail yourself.” We call this Bathroom Surgery. Please don’t try to be a bathroom surgeon. We went to school for a long time to learn how to do this, we have the anesthesia and the proper surgical instruments, and we have a better angle than you do. It will hurt a lot less if we do it for you…besides, even if you try to do it yourself, you will probably still need us to fix the damage you caused and do it anyway.

10. “Don’t wait too long to see a foot specialist if you are in pain.” This one is probably more pertinent to the adults, but I thought I’d throw it in anyway. Most kids are pretty good about telling their parents when their foot, heel, ankle, or calf hurts. I’m not sure why some parents keep this information to themselves for so long before bringing their kids in to see us, but sometimes they do. Severe foot pain in a child can be very serious. It can even be cancer. There are some types of bone cancers that show up in kids in foot bones, so please have it checked out! As for the adults with foot pain…your feet are not supposed to hurt on a daily basis. If they do, there is something wrong. Why wait so long to have it evaluated by a foot specialist? Wouldn’t you rather walk around pain free everyday? I know I would! I’m on my feet at work all day, so if my feet hurt all day, I am not a happy camper…and I’m guessing most of you feel the same way. So don’t wait any longer. Pain-free is the way to be!

Remember, my book is titled "Your Feet Are NOT Supposed to Hurt!" for a reason. :)

To request a free copy, visit my website http://www.footdoc.moogo.com/

Michele Summers Colon, DPM

3503 Lexington Ave.

El Monte, CA 91731

(626) 442-1223

dr.michele.colon@gmail.com

What Would Your FEET Tell Your Teen Self? (part 1)

2010-05-25T10:36:00.000-07:00

I read an interesting MSN article today entitled “What would you tell your teen self?” (http://dove.msn.com/?source=msnhp#/connections/columns/BQ_Response_Columns.aspx[cp-documentid=15892112]?GT1=25039), which was referring to self-esteem. So I started wondering “what would your feet tell your teen self?” in regard to foot health. Here are my top 10 thoughts on this issue, and although some of these seem very obvious to us as adults, they may not be so obvious to kids, teens, or young adults:

Top 10 Things Your Feet Would Tell Your Teen Self:

1. “Don’t wear other people’s shoes.” This can lead to all kinds of foot problems from fungal or bacterial infections to plantar’s warts, foot odor, and even foot pain. It’s never a good idea to share shoes, even among family members.

2. “Don’t walk barefoot in public places.” See #1. The main concern here is plantar’s warts. Warts are viruses that are naked to the eye and enter the skin when you walk barefoot into an area that is contaminated. And warts are painful and difficult to treat. They also have a high recurrence rate, so you definitely do not want to get them!

3. “Don’t wear shoes that are too small or too tight.” This mostly applies to young women who, believe it or not, do not want to admit they are a size 8 or 9 or even bigger. There seems to be a social stigma for women who have big feet, even if they are tall, so many young women try to squeeze their foot into a smaller size shoe. It hurts! Believe me, I’ve tried it once or twice in my teen years, and it’s not worth it. Let’s just embrace our big feet. And if we wear shoes that fit, our big feet will look so much better without blisters and corns on our toes.

4. “Don’t wear high-heeled shoes that are too high.” Another one for the young women. It’s definitely okay for a special occasion, a party, an event, or a night on the town, but not for an everyday ritual. If you have to dress up for work, wear a low-heeled shoe. Your feet will thank you for years to come. Just ask your moms and grandmas…they love to share how they wore high heels for years and how their feet suffer in their golden years for it.

5. “Don’t pop your blisters.” I know it’s tempting, but don’t do it! They will heal on their own if you just leave them alone and stop the friction forces that caused them in the first place. They are usually due to wearing shoes that don’t fit right; shoes that are too big will rub the foot, causing friction, and then causing a blisters to form.

Stay tuned for part 2 tomorrow with #6-10.

Michele Summers Colon, DPM
3503 Lexington Ave.
El Monte, CA 91731
(626) 442-1223

dr.michele.colon@gmail.com

www.footdoc.moogo.com

Follow me on Twitter: @SoCalFootDoc

Kobe Bryant's Ankle Injury Limited Scoring to Five Points!

2010-02-05T09:39:00.000-08:00

KOBE BRYANT SPRAINS ANKLE:

Yes, it's true. Kobe Bryant of the Los Angeles Lakers was held to only five points in Wednesday's game against the Charlotte Bobcats due to injuries, most notably his left ankle. With one of the longest consecutive games playing streak (234), he wants to play this weekend so he is undergoing treatment for his ankle injury, which has been updated to an ankle sprain today.

As an attendee at the Lakers game against the Bobcats on 2/3/10, it was unusual to see Kobe limping off the court. It was also interesting to hear many spectators commenting that he needed to "step it up" or "get his head in the game." But with a moderate to severe ankle sprain, that would be hard to do. Most people did not know at that time about all of his injuries. (He has also been playing with a taped up broken finger.)

Ankle sprains vary in degree from Grade I (mild) to Grade II (moderate) to Grade III (severe), and treatment regimens vary as well, depending on the severity of the injury. Another thing to consider when treating ankle sprains is if there are other associated injuries, such as avulsion fractures of the foot or ankle. Once x-rays and other radiographic studies are performed by a physician to rule out these other injuries, treatment of the ankle sprain can begin.

For any ankle sprain, it is always a good idea to begin with "RICE" treatment:

R stands for rest. The patient needs to keep his or her body weight off of the injured ankle. This could mean complete rest at home, lying or sitting down, using crutches properly while ambulating, or the temporary use of a wheelchair. Whichever method is chosen, it is important to rest the ankle for as long as the physician says to ensure proper healing time.

I stands for ice. In the inital post-injury time period, ice is critical to prevent and limit swelling. If swelling has already set in, the ice can limit further swelling. If swelling has not set in yet, the ice can actually prevent swelling. It limits the inflammation of the injured soft tissue structures. A good rule of thumb is to ice the injured ankle for 20 minutes on, 20 minutes off. The first 48 hours are most critical for the icing. Also, do not apply ice directly to the skin. Place a thin towel between the ice pack and the skin to prevent skin damage.

C stands for compression. The injured ankle needs to be wrapped in a compression dressing. The treating physician will determine which form of compression to use. Compression dressings vary from a simple elastic bandage (like an Ace bandage) to a multi-layer splint to even a cast. It is very important to apply compression as soon as possible post-injury to prevent and control swelling and to limit movement of the injured soft tissue structures.

E stands for elevation. Once the injured ankle is iced and wrapped, it needs to be elevated to limit swelling. Ideally, the extremity should be elevated above the level of the heart. So if the patient is lying down, propping up the foot on two pillows is sufficient. If the patient is seated, extending the leg onto a stool or another chair is better than nothing, but ideally it should be much higher (such as in a recliner with the foot as high up as possible).

As you can see, much of the discussion here relates to controlling and limiting swelling. Remember that the more swelling occurs, the more pain is present and the more healing time is required to recover fully.

***Stay tuned for Part II of this blog discussing what happens to ankle sprains that are not treated properly.

If you have further questions, please do not hesitate to contact Dr. Colon's office:

http://www.footdoc.moogo.com/

Dr. Michele Summers Colon, DPM, MS
3503 Lexington Ave.
El Monte, CA 91731
(626) 442-1223

dr.michele.colon@gmail.com

What If Your Mom or Dad or Grandparent Was Homebound?

2010-01-19T11:59:00.000-08:00

I make house calls for homebound patients.

Sometimes my colleagues and friends ask "Why do you still make house calls? Do you get paid more for them?"

The answer is always the same: I don't do it to make more money. House calls do not pay much more than office visits, and if I'm in the office all day, I can obviously see many more patients than I can if I'm driving from place to place. So it's not for the money.

I do it because I can. I can make a difference in the life of a homebound patient. Some of them have no transportation and no family members to drive them around. Some of them are bedbound in a hospital bed in the middle of the living room. Some of them are in a wheelchair at home alone all day while their family members are at work. Although it may sound sad, they are usually much happier living like that at home than they would be if they were living in a nursing home.

And my house call patients are some of my most grateful patients. They look forward to my visits. We get to know each other while I'm there working away on their feet. Whether I'm treating their corns and calluses, fungal toenails, ingrown toenails, diabetic foot wounds, or fitting them for prescription shoes, we always have time to talk.

I've always had a soft spot for senior citizens since I did not grow up near any of my grandparents, and I love to get to know them. They usually have great stories to tell. I've learned about delivering babies in the 1930's from a retired Ob/Gyn, fighting in the Korean War as well as the Vietnam War, adopting and raising children in the foster care system, nursing practices from retired RN's, singing to the troops at war, working in Hollywood as an actor for decades (I even got to see one of his films as he was in "Home Alone"), and many more interesting stories.

So when people ask me why I make house calls, this is the long answer. But I usually just give them the short one: because I can.

*For more information on house call visits for you or your loved ones in the Greater Los Angeles area, please do not hesitate to call my office and ask.

Dr. Michele Summers Colon, DPM, MS

3503 Lexington Ave.

El Monte, CA 91731

(626) 442-1223

dr.michele.colon@gmail.com

http://www.footdoc.moogo.com/

Author of "Your Feet Are NOT Supposed to Hurt!" & "Sus Pies NO Deberian de Doler!"

10 Common Beginning Running Mistakes to Avoid

2010-01-12T08:45:00.000-08:00

In January we see many people making New Year's Resolutions to get fit and healthier, so many people begin an exercise or running program. As with any new exercise program, it is recommended that beginners consult with their physician before starting. In this article we will discuss some common running mistakes that many beginning runners make.

1. WEARING THE WRONG SHOES: Wearing old running shoes or wearing the wrong type of running shoes for your foot and running style can lead to running injuries. Avoid this by going to a running specialist, where your running style and foot type can be evaluated by a professional. When it is determined that you're an overpronator, underpronator, or neutral runner, shoe recommendations can be made for you. Once you get the right pair of running shoes, make sure you replace them every 300-350 miles because the loss of cushioning can lead to injuries. Your shoes will last longer when you allow them to decompress and dry out between workouts.

2. DOING TOO MUCH, TOO SOON: Many beginning runners make the mistake of doing too much mileage, too fast, too soon. More is not better when it comes to running. As a result, they often start to develop common overuse running injuries, such as shin splints, runner's knee, or ITB syndrome. You should be more conservative than you think you need to be with how often, how long, and how much you run, especially early on in your development. If you're new to running or are coming off a long break, start with walking first, and then progress into a run/walk program.

3. OVERSTRIDING: One of the most common injury-causing running form mistakes is overstriding, or landing heel first with your foot well ahead of your body's center of gravity. A longer stride does not improve speed or running efficiency. Overstriding wastes energy since it means you're braking with each foot strike. You should not lunge forward with your feet. Focus on landing mid-sole, with your foot directly under your body with every step. A short, low arm swing is the key to keeping your stride short and close to the ground.

4. RUNNING OUT OF CONTROL ON HILLS: When running downhill, some people have a tendency to lean way too far forward, overstride, and run out of control. The best way to run downhill is to lean forward slightly and take short, quick strides. Don't lean back and try to brake yourself. Try to keep your shoulders just slightly in front of you and your hips under you. Although it's tempting to overstride, avoid taking huge leaping steps to reduce the pounding on your legs.

5. BAD UPPER BODY FORM: Some beginners swing their arms side-to-side or have a tendency to hold their hands way up by their chest. You'll actually get more tired by holding your arms that way and you'll start to feel tightness and tension in your shoulders and neck. Try to keep your hands at waist level, right about where they might lightly brush your hip. Your arms should be at a 90 degree angle, with your elbows at your sides. Keep your posture straight and erect. Your head should be up, your back straight, and shoulders level. When you're tired at the end of your run, it's common to slump over a little, which can lead to neck, shoulder, and lower-back pain. When you feel yourself slouching, poke your chest out.

6. NOT HYDRATING PROPERLY: Many runners underestimate how much fluid they lose during runs and don't drink enough because they're worried about side aches. As a result, they suffer from dehydration, which can be detrimental to performance and health. Runners need to pay attention to what and how much they're drinking before, during, and after exercise.

7. WEARING THE WRONG CLOTHES: Some runners wear the wrong type or too much or too little clothing for the weather conditions, leaving them uncomfortable and at risk for heat-related or cold weather-related illnesses. Wearing the right type of fabrics is essential. This will wick the sweat away from your body, keeping you dry. It's very important to make sure you don't wear cotton for this layer because once it gets wet, you'll stay wet, which can be uncomfortable in warmer weather and dangerous in cold weather. In the winter, make sure that you don't overdress. In the warmer weather, stick to loose, light-colored clothes.

8. OVERTRAINING: Some runners who are training for specific races or certain goals run too hard, run too many miles, and don't allow for proper recovery time. They assume that running every day will help them get fitter and faster. Overtraining is the leading cause of injury and burnout for runners. You should increase your mileage gradually. Try to give yourself periodic "rest weeks.” After a hard run, take a day off. Rest days are important for your recovery and performance. Add some cross-training activities to your schedule.

9. NOT RUNNING THE CORRECT PACE: When it comes to running long distance races, one of the biggest mistakes that beginners make is going out too fast in the early part of the race. Most runners have ran ahead of pace in the beginning of a race, only to crash and burn during the final miles. The best way to avoid the temptation of going out too fast is deliberately run your first mile slower than you plan to run the final one. Make sure you're in the correct starting position. Don't start yourself with faster runners because you'll most likely try to keep up with them. Start your race at a comfortable pace and make sure you check your watch at the first mile marker. If you're ahead of your anticipated pace, slow down. It's not too late to make pace corrections after just one mile.

10. NOT FUELING PROPERLY: Many beginning runners underestimate the importance of nutrition. What and when you eat before, during, and after your runs has a huge effect on your performance and recovery. Replenish energy as quickly as possible after a workout. If you eat soon after your workout, you can minimize muscle stiffness and soreness. A good rule of thumb for post-workout food is a ratio of 1 gram of protein to 3 grams of carbs. A peanut butter and jelly sandwich, a fruit and yogurt smoothie, and chocolate milk are examples of good post-run snacks. Don't follow a low-carb diet when training. You need a certain amount of carbohydrates in your diet because they're a runner's most important source of fuel.

Dr. Michele Summers Colon, DPM, MS
3503 Lexington Ave.
El Monte, CA 91731
(626) 442-1223

http://www.footdoc.moogo.com/

Does Your New Year's Resolution Include Getting Healthy and Exercising More?

2010-01-09T08:00:00.000-08:00

Warning: Don’t Overdo It!

Now that the first week of January is over, how are you doing with your New Year's Resolutions? Are you one of the millions of Americans who resolve to exercise more this year? If so, take my advice and take it slowly. Too much activity too quickly can cause a multitude of foot and ankle problems, especially overuse injuries. In January, we tend to see a trend in these types of injuries…don’t become a statistic!

Plantar fasciitis, tendonitis and stress fractures are the most common overuse injuries of the foot and ankle. These can be avoided by remembering to include a stretching protocol prior to your workout and following the 'rule of tens' by not increasing your exercise amount by more than ten percent per week.

Let’s take a look at the 3 most common ones:

1. Stress fractures happen with a sudden increase in physical activity. Stress fractures appear as tiny cracks in the bone surface and frequently occur in the metatarsal bones of the foot. Pain is the typical symptom of a stress fracture; it may be sudden or it may gradually increase over several days. Swelling of the foot and lower leg may also occur. This can be easily diagnosed with an x-ray right in your podiatrist’s office.

2. Achilles tendonitis may occur when rapidly increasing running mileage or speed, starting up too quickly after a layoff, or when adding hill running or stair climbing to a training routine. Symptoms of Achilles tendonitis include the following: mild pain after exercise that gradually worsens; a sense of sluggishness in the leg; episodes of diffuse or localized pain, sometimes severe, along the tendon during or after exercise; morning tenderness above the point where the Achilles tendon is attached to the heel; and stiffness and swelling or pain in the back of the heel where the tendon attaches to the bone.

3. Plantar fasciitis, a painful inflammation of the arch or heel area of the foot, typically starts with mild heel pain. The pain classically occurs with the first step in the morning. The pain gradually worsens if not treated promptly.

The best way to avoid these foot and ankle injuries is to know your limits and to follow a sensible program when exercising. Preventative measures include:
-- Select the proper footwear for the specific type of exercise
-- Start out slowly when beginning an exercise program following a
layoff period
-- Walk and stretch to warm up gradually before running or walking
-- Focus on stretching and strengthening the muscles in the calf
-- Increase running or walking distance and speed gradually, in
increments no greater than 10% per week
-- Avoid unaccustomed strenuous sprinting
-- Take the time to cool down properly after exercise

By adhering to these simple measures you may avoid painful overuse ankle injuries and achieve success with your New Year's resolution!

January is "Cash 4 Clunkers" & iStep Foot Scanning Month in our Office

2010-01-02T10:34:00.000-08:00

So what does "Cash 4 Clunkers" have to do with feet and orthotics anyway? We'll explain what it means and what our new iStep foot scanner can do for you too!

We will trade in your old, worn, beat-up orthotics or insoles and evaluate you for brand new orthotics after scanning your feet with the iStep foot scanner. The useful lifetime of a custom made orthotic is usually 3-5 years. This varies based on the materials used, your weight, and your activity. The truth is, your mechanics change. You may have started a new exercise program, gained or lost weight, or suffered an injury…all of which will impact the biomechanics and function of your feet. As your feet change, your current orthotics will not provide the stability that they once did.
Of course, off-the-shelf insoles need to be replaced much more often. Because of the soft, flexible material, they will deform and no longer be supportive.

Now is the perfect time to replace those worn-out orthotics and insoles. Give us a call and tell us that you “have a clunker to trade in” and you’ll receive up to $50 off a new pair of custom orthotics or 50% off a new pair of prefabricated orthotics that we stock in the office. The money comes right off the cash balance of the orthotics once we hear from your insurance company. What if your clunker wasn’t made by our office? No problem! You can take advantage of this program even if you’ve never been to our office before!

If you have a pair of our custom orthotics that are working great, think about a second pair. It’s perfect for dress shoes, high heels, western boots, bike shoes, running shoes, work boots, or just for the convenience of having another pair. If this is something you need, let us know and we’ll give you up to $25 off the cash balance of a custom pair or 25% off of a pair of prefabricated orthotics.

Contact our office at 626-442-1223 today to take advantage of this program. This special offer will end on January 31, 2010.

http://www.youtube.com/watch?v=BH9GikN94a8

Dr. Michele Summers Colon, DPM, MS
3503 Lexington Ave.
El Monte, CA 91731
(626) 442-1223

http://www.footdoc.moogo.com/

My Foot's Christmas Wish List

2009-12-25T15:38:00.000-08:00

5 Things on my Christmas wish list for my feet:

1. My favorite new orthotics for my slip-in Sketchers, Crocs, and operating room clogs are my Lyncos orthotics made by Aetrex. While not as rigid and supportive as custom made functional orthotics, they are a great alternative for times when I need a second pair to keep in an extra pair of shoes that I keep in my gym locker for after my workouts, my gym bag for after my running (i.e. when I wear my Crocs), and in my locker in the O.R. I love them and highly recommend them.

2. My favorite new running shoes from Asics, the GEL Trabuco GT-X. They are light-weight, supportive, and made for trail running. They have a waterproof Gortex upper that is breathable and very comfortable. When I first tried them on, it felt like I was walking on pillows.

3. My new favorite workout socks, Juzo Silver Sole Socks. These socks are ideal for athletes and for those who spend hours on their feet. They are comfortable, provide compression, have a cushioned sole, and help to eliminate germs and odors. I like the ankle length socks for working out and running.

http://www.OurDoctorStore.com/colon/store/item.asp?ITEM_ID=709

4. My new favorite foot cream for dry, cracked skin on my heels, especially during the winter months when everyone's skin gets dry called Calicylic Cream made by Gormel Labs. I love this cream, and so does every patient of mine who has tried it. It makes my feet feel like I just had a pedicure.

5. Dr.'s Remedy Enriched Nail Polishes which protect nails from fungal infections. While most pedicures and nail polishes put toenails at risk for potential fungal infections, this nail polish does the opposite. Plus, it comes in 16 different colors and contains vitamin E & C, wheat protein, tea tree oil, and garlic bulb extract. Who doesn't love a good pedicure, anyway?

http://www.OurDoctorStore.com/colon/store/item.asp?ITEM_ID=694

What foot care items do you want for Christmas?

All of these items are available for purchase in my office www.footdoc.moogo.com or online from my online store www.ourdoctorstore.com/Colon

Have a great holiday!

Michele S. Colon, DPM, MS

3503 Lexington Ave.

El Monte, CA 91731

(626) 442-1223

How Can I Prevent Ingrown Toenails?

2009-12-06T16:15:00.000-08:00

"How can I prevent ingrown toenails?" is a question that I hear in my office almost everyday. Many patients are surprised to find out that the answer is not simple. It depends on the cause. Once we determine the cause of the ingrown nail in that patient, we can recommend how to prevent recurrence.

Onychocryptosis, the medical term for an ingrown nail, has many causes. Let's look at some of the most common causes so we can figure out how to prevent it from happening again.

1. Heredity: Believe it or not, this is the most common cause for ingrown toenails that I see in my office. Usually, the patient states that a family member has had a similar problem at one time or another. In this case, the ingrown toenail will recur over and over again unless it is surgically corrected by a procedure called a matrixectomy. In other words, there is nothing that the patient can do to prevent it (other than having a preventative surgery which will stop part of the nail from growing).

2. Pedicures: Yep, you heard it. Improperly performed pedicures cause many ingrown toenails. This is the second question that I ask the patient who presents with an ingrown nail. (The first question: "Does this problem run in your family?") I generally ask the patient if he or she has had a pedicure recently. Not to my surprise, many times the answer is yes. If the nails are cut too short, cut at an angle, cut crooked, or cut/filed downward on the sides, then the nail can grow downward as it starts to grow. This will eventually cause an infected, ingrown nail. Prevention is easy in this situation: don't get pedicures by people who cut the nails improperly, even if that person is you.

3. Shoes: Although many patients think that this is the only cause or the most common cause of ingrown toenails, this is not true for adults. Adults who are wear shoes that are too tight in the toe box will usually do the sensible thing and stop wearing the shoe. Duh, right? Well, I have seen cases where the patient stated that they thought the shoes were too small or too tight but continued to wear them because they thought that they had to "break in" the shoes. Not true again. Shoes are not meant to be "broken in" to many people's surprise. Shoes should fit when you buy them. If they don't fit in the store, they won't fit later at home. Why would they? That is why we recommend patients to go shoe shopping later in the day when their feet may be a little swollen.

However, improperly fitting shoes can be a common cause of ingrown toenails in young children and babies. Babies can't tell you when the shoe hurts. They will probably cry though, but the parents will usually not know that they are crying about tight shoes. So it is very important for parents to check their child's feet and shoes often for signs of improperly fitting shoes, especially if the child cries every time their shoes are put on them. Again, it seems obvious, but it happens...and it happens often.

4. Trauma: Dropping a heavy object on your toe not only hurts, but it can also push part of the nail down into the skin, causing an ingrown toenail. This also occurs often in athletes who have hit their big toe on something. For example, soccer players kick the ball with the side of their foot, and sometimes they accidentally use the side of their big toe. I see many soccer players in my office who develop an ingrown toenail from improperly kicking the ball. I've also seen it in baseball players who slid into a base and jammed their toe (and toenail).

5. Bone spurs: Most people have heard of bone spurs in the heel bone, called heel spurs. But there is also a type of bone spur that grows upward from the last little bone in the toe, right under the nail. In this case, much like the first case where heredity was the cause, there is not much that the patient can do to prevent an ingrown nail from occurring. This case also requires surgery, but it is more complicated becuase the bone spur will also have to be removed or the ingrown nail will recur.

6. Onychomycosis (nail fungus): Nail fungus deforms the nail. We have all seen thick, discolored toenails on someone. This is usually (but not always) nail fungus, and it can cause deformities and ridges in the nail which will push the nail into the surrounding skin. In this case, prevention will consist of treatment of the nail fungus. There are many treatment options for onychomycosis that your podiatrist can discuss with you.

And although there are other causes of onychocryptosis, the ones listed above are the most common ones that I encounter in my office. I hope this information was helpful to you.

In my office, I focus on preventative medicine and education. Education is the key!

Michele Summers Colon, DPM, MS
A Professional Podiatry Corp.
3503 Lexington Ave.
El Monte, CA 91731
(626) 442-1223

http://www.footdoc.moogo.com/

Are You at Risk for Developing Achilles Tendonitis?

2009-11-30T06:00:00.000-08:00

Risk Factors and Causes:
Achilles tendonitis often develops following sudden changes in activity level, training on poor surfaces, or wearing inappropriate footwear. The condition also may develop in people who exercise infrequently and in those who are just beginning an exercise program, because inactive muscles and tendons have little flexibility. It is important for people who are just starting to exercise to stretch properly, start slowly, and increase gradually. Poorly conditioned athletes are at the highest risk for developing this condition. Participating in activities that involve sudden stops and starts and repetitive jumping, such as basketball, increases the risk for the condition. Patients who develop arthritis in the heel have an increased risk for developing Achilles tendonitis.

Achilles tendonitis may be caused by a single incident of overstressing the tendon, or it may result from a series of stresses that produce small tears over time.

Women who wear high-heeled shoes often and switch to sneakers for exercise also can develop Achilles tendonitis. The Achilles tendon and lower leg muscles gradually adapt to a shortened position because the shoes prevent the heel from stretching all the way to the ground. When this occurs, wearing sneakers or flat shoes forces the Achilles tendon to stretch further than it is accustomed to, causing inflammation. If high heels are worn everyday, stretching should be done every morning and night to keep the Achilles tendon lengthened.

Signs and Symptoms:
In most cases, symptoms of Achilles tendonitis develop gradually. Pain may be mild at first and worsen with continued activity. Repeated or continued stress on the Achilles tendon increases inflammation and may cause it to rupture. Partial or complete rupture results in traumatic damage and severe pain, making walking virtually impossible and requiring a long recovery period. This condition causes the calf muscles to stretch more than normal. The further they stretch, the tighter they become. The force on the Achilles tendon and the heel bone increases, resulting in Achilles tendonitis.

Patients with tendinosis, a chronic inflammation of the tendon, may experience a sensation of fullness in the back of the lower leg or develop a hard knot of tissue called a nodule.

Treatment:
Treatment depends on the severity of the injury. If heel pain, tenderness, swelling, or discomfort in the back of the lower leg occurs, physical activity that produces the symptoms should be discontinued.

If the problem returns or persists, a podiatrist should be consulted. If pain develops even with proper stretching and training techniques, the podiatrist will check for hyperpronation and adequate arch support. The addition of an orthotic may be enough to maintain good arch and foot alignment and eliminate pain.

If damage to the tendon is minor, the injury may respond to a simple course of treatment known as RICE (rest, ice, compression, elevation). A nonsteroidal anti-inflammatory drug such as ibuprofen may be used to reduce pain, swelling, and inflammation.

Additional treatment may be required if injury to the tendon is severe, if mild Achilles tendonitis does not respond to basic treatment, or if symptoms return with the resumption of physical activity.

A flexible cast may be used to immobilize the foot and reduce swelling, and crutches may be used to keep weight off the foot. This treatment may be necessary for up to 8 weeks. If the injury responds to this treatment, the patient may then be advised to wear low-heeled shoes and perform rehabilitation exercises to gradually stretch the tendon before full activity is resumed.

Severe Achilles tendonitis, tendon rupture, or tearing away from the heel bone may require surgery and lengthy rehabilitation. Surgery involves removing the tendon's inflamed outer covering and reattaching the torn tissues. Following surgery, patients undergo physical therapy and strengthening exercises for 2–3 weeks. Most activities can be resumed in 6–10 weeks, and competitive sports usually can be resumed after 3–6 months.

Dr. Michele Summers Colon, DPM, MS
3503 Lexington Ave.
El Monte, CA 91731
(626) 442-1223

http://www.footdoc.moogo.com/

Featured item in our online store this week: Fabrifoam Achilles Healer

http://www.ourdoctorstore.com/colon/store/item.asp?ITEM_ID=516&DEPARTMENT_ID=139

Thanksgiving Causes Foot Problems...But Only If You Let It!

2009-11-26T20:32:00.000-08:00

What is the first thing that comes to mind when you hear the word “Thanksgiving?” For many people, it’s synonymous with “food.” And with food comes problems. That is, with an excess of food or with the wrong food comes problems. These health problems can lead to foot problems and can be attributed to food: (1) obesity, (2) diabetes, and (3) gout.

Obesity:

Obesity is not just an aesthetic issue; it is a contributing cause of musculoskeletal health problems, specifically with the feet and ankles. Many people experience weight gain prior to the onset of foot and ankle pain. People carry approximately four to six times their body weight across the ankle joint when climbing up stairs or walking steep inclines. Obesity may significantly increase the impact Foot and ankle problems can be linked to an individual's weight and body mass index (BMI). Individuals who have a high BMI (> 25 kg/m2) tend to have more foot and ankle problems, see a physician more often for foot and ankle problems, and have more foot and ankle surgery than those who have a lower BMI (< 25 kg/m2). . Increased BMI has also been found to increase foot pressures with standing and walking, and is a precursor to foot and ankle pain.

Diabetes:

Patients with diabetes have most certainly counseled on what they can and cannot eat. However, many diabetic patients present to my office with elevated blood sugar levels. Most of the time, they think that they are following their diet pretty well because they are not eating obvious high-sugar foods such as cakes, cookies, and donuts. What many patients do not realize is that foods such as bread, fruit, coffee or tea (sweetened with sugar) also elevate the sugar levels in the blood, leading to diabetic complications. In the foot, it is seen as numbness, or peripheral neuropathy, which can eventually lead to foot ulcerations, infections, and amputations.

Gout:

All of the foods below can be responsible for excessive uric acid production. Even though some do not contain purines, they can still cause the system to naturally produce uric acid. They are as follows: alcohol, anchovies, asparagus, cauliflower, mushrooms, consommé, herring, meat gravies, broth, bouillon, mussels, sardines, red meats, organ meats, processed meats (hot dogs, lunch meats, etc.), fried foods, roasted nuts, any food cooked in oil, rich foods (cakes, sugar products, white flour products), dark greens vegetables, dried fruits, fish, caffeine, beans, lentils, eggs, oatmeal, peas, poultry, yeast products.
Did you eat any of the foods listed above on Thanksgiving? Did you eat more than one of them? Did you overeat any of them?

While under a Gout Attack all of the above foods should be completely avoided as well as the following foods which are acid-forming: artificial sweeteners, carbonated soft drinks, fizzy drinks, white or wheat flour, goat, lamb, pastries & cakes from white flour, pork, sugar, beer, brown sugar, deer, chocolate, coffee, custard with white sugar, jams, jellies, hard liquor, pasta, rabbit, refined & iodized table salt, black tea, turkey, white or wheat bread, white rice, commercial vinegar.

So…before you over-indulge during your next holiday celebration, think about your body and your feet!

Heel Pain in Children Who Play Sports

2009-11-17T15:07:00.000-08:00

Does your child play sports and complain that his heel hurts? Do you notice your child limping after running? Does your child complain that his heel hurts only during PE? Is your child overweight and complains whenever he has to run? Do any of these sound familiar? Take these complaints seriouisly becuase your child could have Sever's disease.

Who is at risk?
Heel pain in children is usually caused by a disturbance to the growth plate located at the back of the heel bone. This is known as Sever's disease, or calcaneal apophysitis, an inflammation of the growth plate of the calcaneus. It is most common in boys between the ages of 10 to 14 years who play sports with a lot of jumping (like basketball) or other sports that can cause repetitive minor trauma to the heel. It is also more common in children who are overweight, children who have a tight calf muscle, and children who are over-pronators (foot rolls inward when weight bearing).

What are the symptoms?
Pain is usually felt at the back and sides of the heel bone. Sometimes there may be pain on the bottom of the heel. The pain is usually relieved when the child is not active and becomes painful again while running, jumping, or playing sports. One or both heels can be affected. In more severe cases, the child may be limping.

How is it diagnosed?
If your child is complaining of these symptoms, a consultation with a podiatrist will be necessary to rule out other problems. The doctor will need to perform a complete podiatric examination on the child, including a gait analysis and biomechanical measurements. X-rays will also need to be taken in the office. A diagnosis can then be made.

How is it treated?
1. The physician will recommend that the child cut back on sporting activities until symptoms improve; however, if the condition has been present some time, a total break from sports may be needed.
2. Proper shoe gear with a soft cushioning heel lift is important to reduce the pull from the calf muscles on the growth plate. This will also increase shock absorption, so the growth plate is not subject to as much repetitive minor trauma. It is important not to allow the child to walk barefoot until symptoms resolve.
3. Stretching exercises will be prescribed by the podiatrist, provided the stretch does not cause pain in the area of the growth plate. Heel raises and gastrocnemius/soleus stretches will be recommended.
4. The doctor will recommend the use of an ice pack after activity for approximately 20 minutes. This should be repeated 2 to 3 times a day.
5. Since over-pronation is common in these pediatric patients, orthotics will most likely be prescribed for long-term treatment and prevention of recurrence of the pain.
6. Strapping or taping of the foot can also help during activity to limit the ankle joint range of motion.
7. If the symptoms are severe and not responding to the other treatments, anti-inflammatory medications may be prescribed to reduce inflammation.
8. In more severe cases, a below the knee cast or walking boot can be used for 2-6 weeks for immobilization of the foot and ankle.

Don't delay seeking treatment for your child!

For questions, please do not hesitate to call our office for a free consultation at (626) 442-1223.

Dr. Michele Colon, DPM
3503 Lexington Ave.
El Monte, CA 91731
www.footdoc.moogo.com

If I Can Walk On It, It's Not Broken, Right? Wrong!...

2009-10-29T16:16:00.000-07:00

Foot & Ankle Myths:

1. "It can't be broken, because I can move it." Have you ever heard this one? I can't tell you how many times I've been asked this question by patients, friends, and even family members. This is actually what most people think. It's false! This widespread idea has kept many broken bones from receiving proper treatment. The truth is that often you can walk with certain kinds of fractures. Some common examples are fractures of the smaller lower leg bone (the fibula), small chip fractures of the foot or ankle bones (commonly seen with ankle sprains), and fractures of the toes (especially the little toe).

2. "If you break a toe, immediate care isn't necessary." See #1. Many people think that a fracture of a toe doesn't need any treatment. Again, false! All fractures need to be evaluated by a physician. A toe fracture needs prompt attention. If X-rays show that it is a simple, non-displaced fracture, care by your podiatric physician usually can produce rapid relief. However, X-rays might identify a displaced or angulated break. In such cases, prompt realignment of the fracture by your podiatric physician will help prevent improper or incomplete healing. Sometimes fractures do not show up in the initial X-ray. It may be necessary to X-ray the foot a second time, about seven to ten days later. Many patients develop post-fracture deformity of a toe, which results in a deformed toe with a painful corn down the road. A good general rule is to seek prompt treatment for any injury to foot and ankle bones.

3. "If you have a foot or ankle injury, soak it in hot water immediately." Wow! This one is too common! This statement is definitely false. Do not, I repeat, do not use heat or hot water on an area suspect for fracture, sprain, or dislocation in the first 24-48 hours. Heat promotes blood flow, causing greater swelling. More swelling means greater pressure on the nerves, which causes more pain. An ice bag wrapped in a towel has a contracting effect on blood vessels, produces a numbing sensation, and prevents swelling and pain. Your podiatric physician may make additional recommendations upon examination. (Heat may be used later, but your doctor will tell you when and how to use it. Heat has great therapeutic uses in physical therapy, but not in the immediate recovery from an injury!)

4. "Applying an elastic bandage to a severely sprained ankle is adequate treatment." OMG! I hope you all read my latest published article "It's Not Just An Ankle Sprain." http://www.submityourarticle.com/articles/Michele-Colon-4993/ankle-sprain-71233.php I discussed why this one is completely false! Ankle sprains often mean torn or severely overstretched ligaments, and they should receive immediate care. X-ray examination, immobilization by casting or splinting, and physiotherapy to ensure a normal recovery all may be indicated. Surgery may even be necessary.

Blood Clots in Legs from Traveling? Please explain!

2009-10-13T21:57:00.000-07:00

DVT (Deep Vein Thrombosis):
Traveling anytime soon? Wondering about what medical conditions you have that may be affected by air travel? DVT just happens to be one of those conditions. It’s a serious condition that needs to be considered. If you suffer from DVT, consult with your doctor before traveling.

What is DVT?
DVT is a blood clot that develops in a deep vein, usually in a leg, that can break away from the vein wall and travel through the blood to other organs. If it travels to the heart, brain, or lungs, it can cause severe injury or even death.

Risk Factors of DVT:
*Prolonged physical immobility, such as sitting for long periods of time
*Medical conditions, including blood-clotting disorders, cancer, obesity, heart disease, pregnancy
*Personal or family history of DVT
*Medications that affect blood flow, alter blood-clotting mechanisms, or cause blood vessel damage and oral contraceptives/hormone therapy
*Smoking
*Advanced age
*Recent hospitalization, surgery, or trauma

Symptoms of DVT:
Many times there are none, however if symptoms do occur, they include pain, swelling, or redness in the leg. Severe chest pain or problems breathing may indicate that a clot has traveled to the lungs.

Reduce Your Risk of DVT:
*Regularly change leg position, periodically move, and stretch your legs and feet while seated
*Perform leg exercises while seated at least every hour, such as ankle circles, foot pumps, knee lifts, and knee-to-chest pulls
*Get up and walk around from time to time if possible
*Avoid crossing your legs
*Stay hydrated
*Wear loose-fitting clothing
*Wear compression stockings

If you are not sure about your health status before or after traveling, consult with your physician. Your health is at stake!

So Eli Manning has Plantar Fasciitis (Heel Pain)...Let's Find Out What It Is

2009-10-05T19:40:00.000-07:00

THIS IS TAKEN FROM AN INTERVIEW OF DR. COLON (ON HEEL PAIN):

Interviewer: What would you say are the most frequent symptoms that your patients are experiencing whenever they come in to see you when they're complaining of heel pain?

Dr. Colon: The most common symptoms of heel pain that I see in my patients is pain with the first step in the morning. As soon as they get out of bed, they step down on the floor and they have a sharp pain going right into their heel. A lot of times they describe it as it feels like they're stepping on a nail. It sometimes get relieved by walking around a little and later in the day the pain returns again.

The other thing that's very common is the patients come in saying they've had this pain for months. They've tried everything. They've tried Tylenol, over-the-counter anti-inflammatories, even prescription anti-inflammatories from their doctor and nothing is working and then they finally come in to see us.

Interviewer: What causes heel pain?

Dr. Colon: Heel pain has many different causes. It could be due to trauma. There could be a stress fracture in the heel. The most common things though that cause heel pain is an inflammation in the arch or the heel of the foot caused by biomechanical problems when the patient steps down on their foot and when the patient is walking because of the shape of their foot, and sometimes due to recent weight gain. But they're basically walking on the side of their foot instead of on the plantar part of their foot and they're putting a lot of strain and inflammation on their plantar fascial tendon. And so it gets inflamed, and that's called plantar fasciitis.

Interviewer: I see. And so plantar that means the bottom of the foot?

Dr. Colon: Yes. That's the bottom of the foot, all across the arch of the foot and into the heel is where the plantar fascial ligament is located. And any part of that plantar fascial tendon can be inflamed. The most common area is right where it inserts into the heel, right where your arch and your heel meet and once it gets inflamed, it can just radiate up the leg. It can go up into the ankle. It can go around the other side of the foot. But that's where it starts.

Interviewer: Is that the most frequent cause of heel pain that people have when they come in to see you?

Dr. Colon: That's right.

Interviewer: Okay. And are there other things that maybe would cause heel pain as well?

Dr. Colon: Yes, there are other conditions. There's different types of arthritis. A patient can have a nerve entrapment there similar to carpal tunnel in their wrist where they have it in their ankle. There could also be a peripheral neuropathy such as diabetic patients can get extra pain in their heel versus the type of neuropathy that causes numbness. There could also be gout attacking the heel.

Other types of inflammation could be bursitis or tendonitis in the area of the ankle and the heel and patients just basically call it heel pain and sometimes it's actually their ankle or the side of their foot that's hurting them when they show us.

Interviewer: Sure. It's hard sometimes to tell. But for the vast majority of the people, it's really this plantar fasciitis condition that's causing their problems?

Dr. Colon: That's right.

Interviewer: Now how common is heel pain? We talked about it before. I've heard that as high as one in four Americans is going to experience heel pain at some point in their life. Am I right about that?

Dr. Colon: Yes, that's right. It's very common. We see it every day in our office. It's recently been on the rise. The cases of heel pain have increased. I think due to environmental changes in the American way of life. I think there's much more of a sedentary lifestyle than in years past. More people are sitting down on their computers rather than going outside, exercising, and running around.

Especially with children, we see a lot of children that have an increase in weight gain, obese children that are getting conditions such as heel pain, painful flat foot and even childhood diabetes from this phenomenon.

Interviewer: Wow, that's fascinating. Now from what I understand, some extremely high percentage of people, and I think you said before it's over 90% of the people that come in to see you with heel pain, you can cure using what you call conservative measures, which are nonsurgical in nature. Is that right?

Dr. Colon: That's right. Most of the cases can be treated conservatively. And a very small percentage need surgery to cure their heel pain.

Interviewer: Once again, if I ever heard a reason to go see the doctor, that's one. If you're having these kinds of sharp, like feels like there's a nail in the bottom of your foot and you don't go see the doctor and it turns out that over 90% chance that you get this taken care of quite simply and easily, it just seems to me, you wonder why it takes so long sometimes for people to come in. So folks, the big teaching point for me tfoday, again, is just come in and see the doctor because you can get it taken care of.

Now if someone has heel pain and they come in to see you, what can they expect? What happens the first time they come to see you?

Dr. Colon: On their first visit we receive a full podiatric history and physical which includes a full foot examination, ankle examination and a gait analysis. X-rays will be taken in the office and if there's more damage or suspected -- or I suspect something in their tendons that can't be diagnosed on X-ray -- we can send them out for an MRI. But usually we can do everything in the office.

Interviewer: I see. That is just absolutely great. So what could I do, if I don't have heel pain right now and I would like to be one of those three out of four that don't get it, what can I do to prevent heel pain?

Dr. Colon: The biggest thing is to be proactive. Take good care of yourself. Exercise regularly. Keep your weight under control and to wear the proper shoe gear. Obviously don't go barefoot. We want to see people in nice supportive shoes like a nice running shoe, walking shoe. For people with structural deformities, flat foot deformities, they would use orthotics in their shoes and that would prevent them from getting the pain associated with flat foot or other types of foot deformities later that are a result of having flat feet.

Interviewer: That's great. Well Doctor, I want to thank you for taking the time to talk to us today about this because if -- it means 25% of the people that we know have this problem and can have this problem solved.

Dr. Colon: Yes, that's correct. I would invite anyone with heel pain to make an appointment for a free initial consultation at our office. We are located at the following address:

Dr. Michele S. Colon, DPM, MS
3503 Lexington Ave.
El Monte, CA 91731
(626) 442-1223

www.footdoc.moogo.com

Flip-Flop Do's & Don'ts

2009-09-21T11:16:00.000-07:00

Tips to Avoid a ‘Flip-Flop' Fiasco

DO’S:
• Do shop for a flip-flop made of high-quality, soft leather. Leather minimizes the potential for blisters and other types of irritation.
• Do look for flip-flops that hold APMA’s Seal of Acceptance, such as Sole Platinum Sandals. Evaluated by a committee of APMA podiatrists, these products are shown to allow for the most normal foot function and promote quality health.
• Do gently bend the flip-flop from end to end, ensuring it bends at the ball of the foot. Shoes of any kind should never fold in half.
• Do wear a sturdy pair of flip-flops when walking around a public pool, at the beach, in hotel rooms and in locker room areas. Walking barefoot can expose foot soles to plantar warts and athlete’s foot.
• Do ensure that your foot doesn’t hang off of the edge of the flip-flop.

DON’TS:
• Don’t re-wear flip-flops year after year. Inspect older pairs for wear. If they show signs of severe wear, discard them.
• Don’t ignore irritation between toes, where the toe thong fits. This can lead to blisters and possible infections.
• Don’t wear flip-flops while walking long distances. Even the sturdiest flip-flops offer little in terms of shock absorption and arch support.
• Don’t do yard work while wearing flip-flops. Always wear a shoe that fully protects feet when doing outside activities such as mowing the lawn or using a weed-eater.
• Don’t play sports in flip-flops. This practice can lead to twisting of the foot or ankle, as well as sprains and breaks.

Michele S. Colon, DPM, MS
3503 Lexington Ave.
El Monte, CA 91731
(626) 442-1223

www.footdoc.moogo.com

Foot Pain & Weight Loss

2009-09-02T15:52:00.000-07:00

Do your feet hurt? Does your physician tell you to lose weight? Do you ask yourself, how can I exercise if my feet hurt? It’s difficult to lose weight when your feet hurt, but excess weight can cause foot pain. So what do you do when foot pain is preventing you from exercising and losing weight?

Being overweight or obese changes the way the foot functions. Forces on the foot increase dramatically when you carry extra weight. Steps are shorter, the feet are turned out more, and flattening of the foot is increased significantly. Patients who are overweight have generally higher rates of plantar fascitis (heel pain), tendonitis, arthritis, metatarsalgia (pain in the ball of your foot), fractures and sprains of the feet and ankles.

Remember: Your feet are NOT supposed to hurt!

Call for your free "foot book" today! (1-888-737-0558)

Do not ignore pain in your feet and ankles. See your podiatrist if your pain doesn't subside quickly. And to help with the issue of excess weight leading to foot pain, Dr. Colon is offering a weight loss challenge to her patients.

WEIGHT LOSS CHALLENGE:
TO ANY PATIENTS WHO WANT TO LOSE WEIGHT, PLEASE READ THIS!

IN ORDER TO PROMOTE HEALTH & FITNESS IN OUR OFFICE, DR. COLON IS CHALLENGING ANY PATIENT TO JOIN HER IN TRYING TO LOSE WEIGHT DURING THE MONTH OF SEPTEMBER!

ANY PATIENT WHO LOSES MORE WEIGHT THAN DR. COLON WILL WIN A GIFT CERTIFICATE TO iTUNES OR STARBUCKS!

AND THE PATIENT WHO LOSES THE MOST WEIGHT OF ALL WILL WIN AN iPOD SHUFFLE!

Please contact the office for more details:
Dr. Michele Colon, DPM, MS
3503 Lexington Ave.
El Monte, CA 91731
(626) 442-1223
www.footdoc.moogo.com

BACK-TO-SCHOOL SHOE SHOPPING TIPS

2009-08-28T13:15:00.000-07:00

When the final weeks of a care-free summer vacation come to a close,
the sounds of school bells, slamming locker doors and students clamoring
into classrooms are heard loud and clear once again. But before
each new school year begins, parents eagerly seek out a wide array of
school supplies and stylish new fashions for their children. One of the most important purchases on any parent’s back-to-school shopping list is a pair of new shoes. For many parents, back-to-school shoe shopping may seem easier
than a pop-quiz in gym class – but several important factors should be considered:
Children’s feet change with age. Shoe and sock sizes may change every few months as a child’s feet grow.

Back-to-School Shoe Shopping Tips
*Shoes that don’t fit properly can aggravate the feet. Always measure a child’s feet before buying shoes, and watch for signs of irritation.
*Never hand down footwear. Just because a shoe size fits one child comfortably doesn’t mean it will fit another the same way. Also, sharing shoes can spread fungi like athlete’s foot and nail fungus.
*Examine the heels. Children may wear through the heels of shoes quicker than outgrowing shoes themselves. Uneven heel wear can indicate a foot problem that should be checked by a podiatrist.
*Take your child shoe shopping. Every shoe fits differently. Letting a child have a say in the shoe buying process promotes healthy foot habits down the road.
*Always buy for the larger foot. Feet are seldom precisely the same size.
*Buy shoes that do not need a “break-in” period. Shoes should be comfortable immediately.
*Make sure to have your child try on shoes with socks or tights, if that’s how they’ll be worn.

FOR MORE INFORMATION, CONTACT DR. COLON'S OFFICE:
Phone: (626) 442-1223
Fax: (626) 442-0439
Email: drmscolon@msn.com
Website: www.footdoc.moogo.com
Address: 3503 Lexington Avenue, El Monte, CA 91731

MORTON'S NEUROMA

2009-07-24T22:15:00.000-07:00

What is it???

When there is an injury to the nerve that goes to the small toes, the nerve can become swollen. This enlarged nerve then can become pinched between the bones of the forefoot and compressed by the ligament crossing the nerve. This then causes pain and discomfort. A Morton’s neuroma is usually affects the nerve that supplies sensation to the 3rd and 4th toes, but it can occur at the nerve between any of the toes.

What causes it???

A neuroma is often caused by an over-use injury of the foot and toes from a repetitive motion, such as flatfeet or over-pronation during gait. It can also be caused by blunt trauma to the forefoot or direct insult to the nerve. The compression of the nerve over time will cause more severe damage to the nerve and lessen the success of conservative treatments.

What are the symptoms???

When the nerve is compressed, the signals and information the nerve needs to translate to the skin and back to the brain can be decreased. This will lead to numbness, burning, tingling or shooting pains in the toes. There can be a feeling of walking on a pebble or a rock on the ball of the foot. Some patients can feel or hear a clicking as the nerve rubs over the bones while walking or running. Often the symptoms can be reproduced in a squatting position with only the ball of the foot and the toes on the ground and the toes flexed.

How is it diagnosed???

Clinical evaluation of the foot is the most important way to evaluate for a neuroma. Palpation of the foot between and just behind the metatarsal heads will elicit pain and often electric shooting into the toes. Squeezing of the forefoot from side to side can reproduce the symptoms as well. X-rays can show if there is any bone involvement that many contribute to the damage to the nerve. Special neurological examinations may need to be performed in order to evaluate the extent of the nerve damage. Ultrasound examination and MRI can also shoe the enlarged nerve in severe cases.

How is it treated???

In the early stages of a neuroma, conservative treatments are often successful. Removal of the deforming force and activity that caused the damage is important. In acute cases, a period of immobilization in a special shoe or boot may be needed. Physical therapy is a very effective treatment for neuromas that are in the early stages. In acute cases use of cortisone injections can be very helpful in reducing the pain and symptoms and help to cure the neuroma. Custom molded orthotics with special padding is an important part of treatment and lessens the chance for the neuroma to return. In more severe and chronic cases that have failed conservative therapies, there are more invasive treatments available, including sclerosis, cryotherapy, nerve decompression, and nerve excision. Each treatment has benefits and setbacks, and treatment is customized to the patient’s needs.

Most importantly, see your podiatrist if you have symptoms of a Morton's neuroma. Remember: The sooner you begin treatment, the better chance you have for a quick and full recovery.

Skateboarding Injuries

2009-07-18T22:34:00.000-07:00

Many children, teens, and young adults love the thrill of skateboarding. They learn to master jumps and tricks such as "riding the rail" and "catching air." But according to the American College of Foot and Ankle Surgeons (ACFAS), such skills can be physically demanding and cause serious foot and ankle injuries.

Foot and ankle surgeons continue to see serious lower-extremity skateboard injuries among their patients. These injuries include minor bruises, open wounds, ankle sprains, and fractures of the foot and ankle. Some of these injuries are severe enough to require surgical repair. Skateboarders are advised to use caution and wear protective gear, including properly supportive shoes, when skateboarding. Skateboarding can be particularly hard on your feet and ankles because of the impact caused when performing jumps and tricks.

Skateboarders should be aware that the strain from repetitive, forceful motions can also cause painful foot and heel conditions such as plantar fasciitis, bone spurs, and Achilles tendonitis. Even minor cuts or abrasions on your feet can cause serious problems. It is important to see a podiatrist to ensure proper diagnosis and course of treatment for these injuries. Until you can be seen by a doctor, it is best to take a break from activities and use R.I.C.E. (Rest, Ice, Compression, and Elevation) therapy, which helps to reduce pain and control swelling. A common misconception about foot and ankle fractures is that if you can walk on the foot, there isn't a fracture. That's not always the case, and only a proper diagnosis can rule out a serious injury requiring an advanced treatment plan.

Even Supreme Court nominees need podiatrists!

2009-06-08T12:40:00.000-07:00

Supreme Court nominee Sonia Sotomayor broke her ankle Monday morning in an airport stumble, then boarded her flight to Washington and met with senators who will vote on her confirmation.

According to the White House, the federal judge, who has been keeping up a busy set of appointments on Capitol Hill, tripped at New York's LaGuardia Airport and sustained a small fracture to her right ankle. She entered the Capitol on crutches, wearing a below the knee cast.

Which bones are involved in an ankle fracture?
The ankle is a complex joint that forms where the tibia, fibula, and talus bones come together. Both the tibia and the fibula wrap around the talus to form the ankle joint. The bony prominences at the ankle are called the medial malleolus (the end of the tibia) and the lateral malleolus (the end of the fibula). The ends of these bones for a cup for the talus to sit within.

The Broken Ankle
When a broken ankle occurs, the injury may be to the talus, the medial malleolus or to the lateral malleolus, or a combination of these bones. There are many different type of ankle fractures. The point is, every ankle fracture MUST be treated individually. You must see your foot doctor and go over the treatment plan with him or her.

Common symptoms of an ankle fracture include:
Pain to touch
Swelling
Bruising
Inability to walk on the leg
Deformity around the ankle

If an ankle fracture is suspected you should see your doctor or go to the emergency room. X-rays will be done to determine the extent of the injury. Other injuries may also occur around the ankle joint, including ankle sprains, Achilles tendon ruptures, and other problems that may be confused with a broken ankle. It is important to be properly evaluated so that a treatment plan can be developed.
Once the injury has been determined, a treatment plan is made that is appropriate for the type of ankle fracture, such as a below the knee cast like the one Sonia Sotomayor has.

“Your child will outgrow it” is NOT always the correct answer!

2009-06-03T11:05:00.000-07:00

FLAT FOOT IN CHILDREN

Flat foot is common in children and is usually inherited. When the child stands, there is a noticeable flattening or collapsing of the arch. Many children with flat foot do not complain of symptoms, but some can have serious aches and pains.

Symptoms of pediatric flat foot may include pain and tenderness in the foot or leg, outward tilting of the heel, difficulty running and walking, excessive shoe wear, difficulty fitting shoes, excessive tripping and falling, and constant complaining when running or participating in sports.

There are different kinds of flat foot. It may be symptomatic or asymptomatic. It may be flexible or rigid. In flexible flatfoot, it looks like there is an arch when non-weightbearing, but it fully collapses on weight bearing; this is the most common type and is associated with many overuse injuries in child athletes. In rigid flatfoot, the arch is always stiff and flat; this is less common and usually due to abnormal bone structure or bone growth during development.

How is flat foot diagnosed?
In pediatric flat foot, the podiatric foot and ankle surgeon will do a complete biomechanical exam to see how the feet, knees and hips function. X-rays are taken to evaluate the growth plates and bone growth. Sometimes, an MRI or CT scan are needed to fully evaluate this complex deformity.

How is flat foot treated?
In asymptomatic flat foot, preventative treatment includes proper shoe gear and orthoses. Secondary symptoms of “Charlie horses” (leg cramps), tired feet, and knee and hip pain should be discussed with parents. Weight loss is always recommended for overweight pediatric patieints due to the high incidence of painful flat feet in the obese child.

In painful flat feet, treatment is required. No child should be in pain due to their feet. Activity modification, changes in shoe gear, stretching exercises, anti-inflammatories and custom made orthoses are the mainstay of therapy. Often, significant flat feet will need physical therapy for more aggressive symptomatic relief.

Surgery should only be an option for pediatric flat foot if the child is having severe difficulty walking or running, has undergone at least 6 months of aggressive therapy and has a significant deformity.

Contact our office for a biomechanical exam if your child is experiencing fatigue, cramping or pain associated with flat feet or if your are concerned about your child’s flatfeet and your pediatrician said “your child will outgrow it.”

Got Gout?

2009-04-23T09:44:00.000-07:00

What is it anyway?

Gout is a common, recurrent condition of joint inflammation in which crystals of uric acid are deposited within joints. It is due to a uric acid overproduction or uric acid under excretion by the kidneys resulting in higher uric acid blood levels. More commonly seen in men than women, it most often appears in the big toe joint but can involve any of the joints of the limbs. If gout is left untreated, the joints involved may be damaged and surrounding tissues also may become inflamed. Kidney stones are also a possibility. 5-10% of the population normally have a high blood level of uric acid, called hyperuricemia, but they do not have symptoms and are therefore not considered to have gout.

There are many factors that increase the risk of gout. Some medications may cause gout, such as diuretics and some antibiotics. Gout is more likely to appear with disorders like leukemia, polycythemia, thyroid disease, kidney disease, high blood pressure, diabetes, high cholesterol, anemia, coronary occlusive disease, and blood vessel diseases. Other things to consider are a family history, age 50 or higher, male gender, obesity, trauma or surgery, emotional stress and chemotherapy or radiation treatments. Even diet can play a role as large amounts of certain foods can lead to a problem.

Signs and symptoms:

* Sudden, severe joint pain (within hours), especially the big toe. Sometimes the weight of bed sheets may even be intolerable. The individual may be awakened from sleep due to the sudden pain.
* Joint is red, hot and swollen.
* Skin overlying the swollen joint may be tight and shiny.
* Painless, firm nodules on the external cartilage of the ear, sometimes seen on the fingers, hands, feet, Achilles tendon and under-surface of forearm. This is rare and usually occurs over time; it happens in what is known as chronic tophaceous gout. The nodules are called tophi (singular is tophus).

Treatment:

* Diagnosis - joint fluid analysis, blood levels of uric acid (which can be misleading and is not diagnostic of gout by itself), x-rays and bone scan.
* NSAIDs (nonsteroidal anti-inflammatory drugs).
* Medication to decrease production of uric acid, such as allopurinol.
* Medication to increase excretion of uric acid by the kidneys, such as probenecid.
* Other medications - colchicine, indomethacin, prednisolone.
* Warm or cold compresses on affected joints.
* Keep bedclothes off of painful joint; design a frame that raises the sheets and blankets.
* Diet - avoid sardines, liver, kidney, sweetbreads, and anchovies. Drink lots of water to help flush out the kidneys and prevent stone formation.
* Avoid alcohol as it can trigger or worsen a gouty attack.
* Lose excess weight but do it slowly and under the guidance of a physician. Crash diets with rapid weight loss can trigger an attack.
* Get rest during a gouty attack.
* Discuss the side effects of all other medications you are taking. Understand the side effects of the medications you do take for gout.

Call our office if you develop new symptoms, especially fever over 101 degrees, sore throat, rash, red tongue, bleeding gums, sudden swelling or weight increase, diarrhea or vomiting. If the medication you are prescribed to treat your gout does not improve symptoms within three days, let us know.

Michele S. Colon, DPM
3503 Lexington Ave.
El Monte, CA 91731
(626) 442-1223

Running & Walking for the Cure

2009-03-25T13:09:00.000-07:00

To all my fellow runners AND walkers,
The Susan G. Komen Race for the Cure in LA was a great success! I met so many runners, cancer survivors, family members of cancer survivors, philanthropists, volunteers, and people who care. It was so nice to see so many supporters for such a worthy cause. It was a great day to be at the Rose Bowl in Pasadena. I mean, if you're not there for football, it may as well be for a great cause like this!

My question to you is: Would anyone like to join me in The Breast Cancer 3-Day, a 60-mile walk (for women and men) who want to make a difference in the fight against breast cancer?

We will walk 60 miles in three days and help raise millions of dollars for breast cancer research and patient support programs. Each night, walkers will get the chance to be a part of an incredible mobile city that's more than just sleeping tents and warm showers. It's a place where we can eat, relax, and renew our spirit with fellow walkers. The Breast Cancer 3-Day benefits Susan G. Komen for the Cure® and the National Philanthropic Trust Breast Cancer Fund.

For more information and to register, visit www.the3day.org, or call 800-996-3DAY to walk the Breast Cancer 3-Day in a city near you.

2009 Locations:
Boston July 24-26
Cleveland July 31-August 2
Chicago August 7-9
Michigan August 14-16
Twin Cities August 21-23
Denver August 28-30
Seattle September 11-13
San Francisco October 2-4
Washington, D.C. October 9-11
Philadelphia October 16-18
Atlanta October 23-25
Tampa Bay October 30-November 1
Dallas November 6-8
Arizona November 13-15
San Diego November 20-22

I'll be walking in the San Francisco or San Diego event, depending on you, my peeps. I'd like to get a group together to walk with me. Let me know if you want a walking buddy!

GOT HEEL PAIN?

2009-03-04T14:50:00.000-08:00

In the past several years, the incidence of heel pain has been on the rise with an epidemic-size magnitude.

Consider: 25% of Americans will be affected by heel pain sometime in their lives!
Far too often, patients wait to see me about their heel pain until it becomes unbearable. Please know that you do not have to suffer! Heel pain can be treated early and quickly eased without the need for surgery over 95% of the time. If you come in at the first sign of pain, it is almost guaranteed that together we can fix whatever the heel problem is.

Why this epidemic?
There are many reasons to explain this phenomenon, but three factors stand out:
1. Non-supportive footwear. Flip-flops and soft sandals are not only unsupportive, but can set one up for injuries due to foot instability in these flimsy but popular types of footgear.
2. Our increasingly athletic lifestyles: this is a seeming paradox because exercise has so many healthy benefits.
3. Increasing obesity: carrying extra pounds increases strain on all foot structures which can lead to strains, sprains and other pathology that can result in foot pain.

The common thread in most all types of heel pain is a hereditary foot imbalance that causes overuse and strain of the foot supporting structures. This intricate network of anatomical parts must be balanced properly in order to prevent foot, leg, hip, and back pain.

By far,the most common type of heel pain is pain on the bottom of the foot, called Plantar Fasciitis. This is due to inflammation of the attachment of the plantar fascia where it connects to the heel bone.

The typical symptoms are pain when arising from bed or a sitting position. If treated early when symptoms first appear, the problem can be easily treated. Delay lengthens treatment time and risks the need for surgery.

DIABETES

2009-02-26T13:46:00.000-08:00

If You Have Diabetes Already . . .

Do:

1. Wash feet daily.
Using mild soap and lukewarm water, wash your feet in the mornings or before bed each evening. Dry carefully with a soft towel, especially between the toes, and dust your feet with talcum powder to wick away moisture. If the skin is dry, use a good moisturizing cream daily but avoid getting it between the toes.

2. Inspect feet and toes daily.
Check your feet every day for cuts, bruises, sores or changes to the toenails, such as thickening or discoloration. If age or other factors hamper self-inspection, ask someone to help you, or use a mirror.

3. Lose weight.
People with diabetes are commonly overweight, which nearly doubles the risk of complications.

4. Wear thick, soft socks.
Socks made of an acrylic blend are well suited but avoid mended socks or those with seams, which could rub to cause blisters or other skin injuries.

5. Stop smoking.
Tobacco can contribute to circulatory problems, which can be especially troublesome in patients with diabetes.

6. Cut toenails straight across.
Never cut into the corners, or taper, which could trigger an ingrown toenail. Use an emery board to gently file away sharp corners or snags. If your nails are hard to trim, ask your podiatric physician for assistance.

7. Exercise regularly.
As a means to keep weight down and improve circulation, walking is one of the best all-around exercises for the diabetic patient. Walking is also an excellent conditioner for your feet. Be sure to wear appropriate athletic shoes when exercising. Ask your podiatric physician what’s best for you.

8. See your podiatric physician.
Regular checkups by your podiatric physician—at least annually—are the best way to ensure that your feet remain healthy.

9. Be properly measured and fitted every time you buy new shoes.
Shoes are of supreme importance to diabetes sufferers because poorly fitted shoes are involved in as many as half of the problems that lead to amputations. Because foot size and shape may change over time, everyone should have their feet measured by an experienced shoe fitter whenever they buy a new pair of shoes.

New shoes should be comfortable at the time they’re purchased and should not require a "break-in" period, though it’s a good idea to wear them for short periods of time at first. Shoes should have leather or canvas uppers, fit both the length and width of the foot, leave room for toes to wiggle freely, and be cushioned and sturdy.

10. Don’t go barefoot.
Not even in your own home. Barefoot walking outside is particularly dangerous because of the possibility of cuts, falls, and infection. When at home, wear slippers. Never go barefoot.

11. Don’t wear high heels, sandals, and shoes with pointed toes.
These types of footwear can put undue pressure on parts of the foot and contribute to bone and joint disorders, as well as diabetic ulcers. In addition, open-toed shoes and sandals with straps between the first two toes should also be avoided.

12. Don’t drink alcohol in excess.
Alcohol can contribute to neuropathy (nerve damage) which is one of the consequences of diabetes. Drinking can speed up the damage associated with the disease, deaden more nerves, and increase the possibility of overlooking a seemingly minor cut or injury.

13. Don’t wear anything that is too tight around the legs.
Pantyhose, panty girdles, thigh-highs or knee-highs can constrict circulation to your legs and feet, as can men’s dress socks if the elastic is too tight.

14. Never try to remove calluses, corns, or warts by yourself.
Commercial, over-the-counter preparations that remove warts or corns should be avoided because they can burn the skin and cause irreplaceable damage to the foot of a diabetic sufferer. Never try to cut calluses with a razor blade or any other instrument because the risk of cutting yourself is too high, and such wounds can often lead to more serious ulcers and lacerations. See your podiatric physician for assistance in these cases.

STRESS FRACTURES

2009-02-05T14:54:00.000-08:00

Why does it always seem to be the case that when we finally get motivated enough to start exercising on regular basis, or when we have been exercising on regular basis and have finally “found our groove”, we develop some pain in your body that slows us down! More often than not, this pain happens in one foot! Not both, just one. Strangest thing!

We are talking particularly about a pain in your foot that picks up when you exercise and decreases, or goes away when you rest. You try to figure out why you are having pain when you swear you did not drop a turkey on it! There is no bruising with this injury, though swelling can occur, usually after you have been on your feet for while or after exercising.

Well, you may just have a stress fracture! It does not have to hurt all the time, but you can definitely get going when you press on it!

A stress fracture is a hairline fracture in bone. It is typically caused by repetitive stress on the bone over a period of time. Bone does breakdown and build up in response to stress, but sometimes the stress being produced overwhelms the body's ability to respond to it. This is when a stress fracture occurs. We have seen stress fractures present in so many different situations, it can honestly be said that a stress fracture can happen to anyone, even if you don't exercise! Where do we go from here?

Having a stress fracture gives you the perfect excuse to rest rather than try to work through the pain. In fact, trying to work through the pain can downright convert your hairline fracture into a full-blown displaced fracture! Not a good idea! Play it smart, listen to your body and have your foot evaluated.

Oddly enough, a stress fracture is diagnosed on clinical exam, not by x-ray. In fact, the x-rays we take may not show your fracture initially since it can take almost two weeks for a hairline fracture to show up on film. The good news is that if we do not see it on x-ray, you have not converted your hairline fracture into a full-blown one and have come just in the nick of time!

In the cases where a stress fracture is diagnosed, treatment usually consists of some form of immobilization. It can take up to three to four weeks for a stress fracture to properly heal, if it is properly taken care of. And, as with most podiatric medical conditions, the sooner you are diagnosed, the quicker we can get you back up on your feet again!

MICHELE S. COLON, DPM
3503 LEXINGTON AVE.
EL MONTE, CA 91731
(626) 442-1223
dr.michele.colon@gmail.com

FUNGAL TOENAILS

2009-01-16T11:20:00.000-08:00

ONYCHOMYCOSIS:

My nails are thick, yellow and seem to have something growing underneath them. I’m not a dirty person, how did this happen?

Toe nail fungus strikes across class, ethnic, age and hygiene lines. In fact, one study showed that almost 50% of people over the age of 40 have experienced some type of toenail fungus. Fungal infections are incredibly common, but are more prevalent in athletes (due to toenail trauma) and the infirmed (due to a decreased immune response).

The typical athlete’s foot fungus, called a dermatophyte, is the same fungus that infects your toenails. Fungus loves a moist, dark environment like in your shoes, between your toes. The affected toenails can have a whitish superficial infection or a yellow to brown discoloration under the toenails that seems to destroy the nail as it grows. Long standing fungal toenail look like thick, brownish-yellow mountains growing on the end of your toes. The thickness makes them painful and susceptible to a secondary bacterial infection (paronychia). This infection can be quite dangerous and has been linked to gangrene in diabetics.

How is toenail fungus diagnosed? Diagnosis of onychomycosis can only be made by a toenail biopsy. Your podiatrist can take a small piece of the leading nail and send it for a special stain that shows the fungus. A PAS stain is usually faster and more accurate than a fungal culture, because often the fungus does not grow in the laboratory. Do not assume you have onychomycosis. Psoriasis and other skin disorders as well as chronic trauma can look like fungus. Also, a melanoma under the nails can mimic fungus, but can be deadly if there is a delay in diagnosis. If you suspect you have toenail fungus, don’t delay, see your podiatrist today!

How can I prevent toenail fungus?
1. If you get regular pedicures, bring your own instruments or go to a spa that sterilizes their instruments in an autoclave (like our foot spa).
2. Clean your toenail clippers with alcohol before you use them if you do your own toenails and make sure to replace Emory boards and orange sticks regularly.
3. We also recommend you regularly clean your shoes with either antibacterial spray like Lysol or even better an antibacterial with an antifungal like Mycomist at least once a month and dry them with a hairdryer.
4. Changing socks regularly (even a few times a day if you have sweaty feet) and keeping your feet clean and dry is also helpful.
5. Keep your athletic shoes dry and also change them regularly. If you exercise regularly, buy your athletic shoes a half size larger than your street shoes so you won’t bash your toenails as your feet swell with exercise.

How is toenail fungus treated?
There is a lot of misinformation out there about toenail fungus. I have never told my patients to use white iodine, Vic’s Vaporub or organic cornmeal soaks on their toes. There is no evidence that it works.
Topical therapy should have some penetration of the nail plate like Tineacide (my favorite), organic tea tree oil, Nailstat, or prescription ciclopirox (generic Penlac) nail lacquer. This should be coupled with a nail treatment plan from your podiatrist.
If this doesn’t work after several months, oral medication, like terbinafine (generic Lamisil) or itraconazole (generic Sporonox) may be needed.

Remember, no matter how you treat fungal toenails, it takes at least 6 to 12 months for the toenails to grow out completely. Relapse is also common, so it’s important to play offense (treat the fungus) and defense (try to prevent the fungus) at the same time.

We have free patient brochures related to this topic in our office in English and Spanish.

Shoe Shopping

2009-01-09T10:59:00.000-08:00

FINDING THE RIGHT SHOE:
The wrong shoes can cause or aggravate foot ailments. The right shoes can often prevent - but cannot correct - problems. So wearing the right shoes is vital to foot health. Follow these simple suggestions when picking out shoes. If problems persist, visit our office and we will be happy to help you.

Construction:
Leather is best because is breathes like skin and molds to your foot. But cheaper canvas is fine for fast-growing children. Breathable mesh is also good especially in athletic shoes. Soles should be strong and flexible with a good gripping surface.
Insoles should be cushioned to absorb the jolts of walking on hard surfaces, but have enough arch support for your foot type. Some people require custom insoles for good foot health and comfort. Arch supports distribute weight over a wider area. Rigid shanks also give added support.
High heels can be fun and look good, but they should not be worn too long at a stretch or for much walking. Besides cramping the toes, they change the biomechanics of your whole body making back pain, foot strains and aggravation of foot deformities more likely.
Thongs and ballerina flats with no support are just as bad and can cause and aggravate many foot ailments.

Fit:
Only you can tell if shoes fit. If they aren't comfortable, don't buy them! A properly trained foot specialist such as a podiatrist or pedorthist can suggest the proper shoe size. Don’t be surprised if you are wearing two shoe sizes too small.
Don't plan on shoes stretching with wear. If you already own shoes that are too tight, ask your shoe repair shop if they can be stretched. Better advice would be to replace them.
Because feet spread with age, have your feet measured every time you buy shoes. Especially if you have had recent weight gain or pregnancy. Both feet should be measured as they are often different sizes. Always buy shoes for the BIGGEST foot.
Go shoe shopping late in the afternoon. Feet swell to their largest later in the day. If you must buy shoes in the morning, buy them slightly larger.
Size depends on shoe make and style, too. Don't insist you always wear one size if the next feels better. Remember the size is merely a suggested number and changes with brand and style.
The toe box should be roomy enough so you can wiggle all your toes. You should have one thumb width from the end of your longest toe to the end of the shoe. Remember this may be your second toe not your great toe.
Your forefoot should NOT be wider than your shoe. Look to see if your foot is spreading out over the sole of the shoes at the sides.
Unfortunately, most shoes today are narrower in the front than the foot is. You can check this by standing on paper and tracing around your bare foot. Compare the outline of your foot with the sole of your shoe. If your shoe appears too narrow, you may be asking for foot problems. Choose only shoes that feel comfortable - you are the best judge of that.
The heel should fit snugly and the instep should not gape open.
And finally, if the shoe doesn’t fit - don’t buy it!

Fitting Children’s Shoes:
Good shoes are especially important to avoid problems in developing feet.
Because shoes serve only to protect children's feet from injury, none are needed before a child walks.
High-topped infant shoes do not support ankles - oxfords and tennis shoes are equally good.
Check OFTEN to be sure shoes aren't too small. Children's feet are so flexible they can be crammmed into shoes two sizes too small - and the child may not complain.
Don't have children wear hand-me-down shoes. They are permanently molded to the original owner’s feet.
And remember, kids with a family history of foot problems like bunions and flat feet can benefit from custom foot orthotics as young as 18 months old to slow down the progression of some inherited foot deformities.

Dr. Colon

Information about foot pain

2008-11-08T17:12:00.000-08:00

Hello everyone! This blog was created to keep my patients, friends, and family informed about their feet and ankles with up-to-date articles and medical expertise.

Dr. Colon