Those looking to cool off from hot temperatures around Columbus ought to be careful when going to visit any Lake Erie beaches in Ohio. Recently, environmental research has been released on how many times last summer E. coli bacteria were a threat to swimmers at coastal beaches. Unfortunately, E. coli was detected a higher number of times along Ohio’s Lake Erie beaches compared to any other coastal beach sites tested. The presence of disease causing bacteria at lake beaches can potentially cause dangerous tissue infections in the feet without proper care and precautions.

Bacteria and the infections they cause take a different course depending on a number of variables. While the severity of an infection and how the infection manifests itself may vary, one relative constant factor in developing a foot infection while in an aquatic environment is: the presence of a trauma or wound in the skin. Most bacteria found in lakes are unable to penetrate through intact skin to cause infection. However, when a scrape, cut or ulceration is present in the foot the bacteria may enter and cause disease. Signs of wound infection include: swelling, redness, increased skin temperature, pain, drainage from the wound and odor. Some infections acquired in a lake may have an unusual appearance. Bacteria called pseudomonas aeruginosa may cause wound drainage to have a blue-green appearance. These bacteria may also cause “Green Nail Syndrome” in individuals with prolonged exposure to the bacteria in water, in which the toenails appear greenish-black. If a wound infection progresses without being properly treated it may reach the bloodstream and manifest with system-wide symptoms of fever, nausea, vomiting and chills.

In order to prevent such infection from occurring, feet should be thoroughly inspected for the presence of any open wound before entering an aquatic environment. Even a small cut such as a nick while shaving the legs or a toenail being cut too short during a pedicure can allow bacteria to enter. By being aware of the wound and its appearance prior to a visit to the beach, it may be determined that water should be avoided altogether or, at a minimum, care may be taken to note if any changes occur. All wounds on the foot should be properly cleansed and cared for regardless of whether or not an individual will be entering water. Individuals with diabetes or other immune conditions should take extra precautions with care of wounds to avoid infection. With awareness and regular excellent foot care, Columbus travelers should have a safe and fun time cooling off at any beach they choose this summer!

Please visit www.ColumbusFoot.com for more tips for healthier and happier feet or call 614-885-3338 (FEET) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

Columbus Podiatry & Surgery has opened a new location in Gahanna, near Easton. Please call 614-476-3338 (FEET) for an appointment with a podiatrist in Gahanna, OH today.

At the annual Red, White and Boom fireworks celebration last week for the 4th of July in Columbus, the summer season of fireworks, festivals and bonfires reached one of its high points. Luckily, very few injuries were reported during the celebrations on the 4th and the days following, however foot burns are a serious risk during many of these summer events. Burn wounds of the foot represent a unique and difficult area to treat.

Burns can occur from heat, electricity, chemicals or friction. In the foot, a recent study reported that most burns were due to scalding injuries. Burns can appear differently depending on severity. First degree burns affect only the most superficial skin layers and cause skin to appear dry and red. Second degree burns can vary in appearance from red with clear blisters to yellow or white. Second degree burns can also appear moist or dry and may be very painful or feel just an uncomfortable pressure sensation depending on how deep tissues were damaged. Third degree burns are also known as full thickness burns, as the entire thickness of the skin is damaged. Tissue will appear leathery and these wounds are typically painless. Fourth degree burns are the most serious and extend into underlying fat, muscle and bone. As a burn progresses from first to fourth degree, the severity of the wound and length of time required for healing increases.

Like other foot wounds, pressure caused by walking or standing must be removed in order to allow skin and underlying tissue to heal. Whether the wound is due to a burn, pressure or arterial disease, healing will be slowed in the presence of excess pressure. Offloading of the wound with customized orthotics or padding may be possible for small burn wounds. Wounds involving a large portion of the foot may require prolonged non-weightbearing or even hospitalization in order to alleviate pressure. Early treatment of burn wounds on the foot is crucial in order to decrease the occurrence of serious complications including infection, delayed healing, difficulty ambulating and prolonged bedrest. The likelihood of developing a complication is increased in smokers and individuals with diabetes and peripheral vascular disease. Individuals with diabetes and peripheral neuropathy are also at a higher risk of obtaining a burn wound due to lack of sensation. Space heaters and excessively hot foot soaks are dangers which individuals who lack foot sensation need to be aware of as a potential risk of a burn.

Please visit www.ColumbusFoot.com for more tips for healthier and happier feet or call 614-885-3338 (FEET) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

Columbus Podiatry & Surgery has opened a new location in Gahanna, near Easton. Please call 614-476-3338 (FEET) for an appointment with a podiatrist in Gahanna, OH today.

The San Francisco Giants activated infielder Pablo Sandoval this past Monday after tendon pain in his foot had placed him on the disabled list for 15 days. Pablo is reported to have injured his peroneal tendons, a relatively common foot problem for athletes. Unfortunately for highly active individuals like Pablo, depending on exactly what structures are damaged around his tendons, surgery may eventually be necessary to achieve optimal function.

The two peroneal tendons that are injured are called the peroneus longus and peroneus brevis. These two tendons course directly adjacent to each other along the lateral side of the ankle and foot, where they are held in place by a fibrous band called the superior peroneal retinaculum. There are a variety of possible conditions that can develop with the peroneal tendons. Tendonitis may occur, in which the tendons become irritated and inflamed. This could be a portion of Pablo’s injury, as tendonitis is typically caused by repetitive activity, which is common during practice for high level athletes. Accessory bones and muscles can also develop and interfere with the normal function of the peroneal tendons. An extra bone called an “os peroneum” develops in about 20% of the population within the peroneus longus tendon. Like any other bone in the foot, the os peroneum can become fractured and cause pain. This accessory bone can also contribute to the development of tendonitis by irritating the tendon and disrupting its normal course. Having a supinated foot, which usually appears as a high arch, can also increase stress on the peroneal tendons. Supination causes the heel to be inverted, or “roll” inwards, increasing the work the two tendons must perform to maintain a relatively normal foot position during gait.

Conservative treatment is an excellent initial option, which is likely the treatment Pablo began with during his time on disability. Remaining off of the affected leg and taking non-steroidal anti-inflammatory medications can aid in reducing pain and inflammation around the tendons. Custom orthotics can be extremely helpful in controlling the abnormal foot structure and function that contributed to the development of tendonitis. Physical therapy to maintain proprioception is also a key portion of treatment, especially for athletes. After several months of these less invasive treatments, surgery may become necessary. Damaged tendons may need to be surgically repaired, the peroneal retinaculum may need to be tightened to better maintain the position of the tendons, or a painful accessory bone may need to be removed. Additional diagnostics studies such as an MRI or ultrasound are obtained as needed to aid your podiatrist in developing an appropriate surgical plan.

Please visit www.ColumbusFoot.com for more tips for healthier and happier feet or call 614-885-3338 (FEET) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

Columbus Podiatry & Surgery has opened a new location in Gahanna, near Easton. Please call 614-476-3338 (FEET) for an appointment with a podiatrist in Gahanna, OH today.

This past week contestants from around the world gathered in Derbyshire, England to show off their skills in an unusual sporting event: toe wrestling. The world toe wrestling championships began in the 1970s and have continued annually ever since. The competition requires not only toe and foot strength to maintain position in the match, it also requires good motion of the big toe joints.

When motion becomes limited or painful in any joint, arthritis, or inflammation of the lining of the joint has likely developed. In the foot, the joint at the base of the big toe, known as the metatarsophalangeal joint, is commonly affected by this condition specifically called hallux limitus. Trauma is the number one trigger in the development of this arthritis, either a single episode such as dropping a heavy object on the toe or repetitive low grade trauma that may occur in sporting events. Underlying structural deformities in the foot may also contribute to joint damage in the big toe. A long or short 1st metatarsal bone as well as an elevated 1st metatarsal may cause increased wear and tear on the joint.

In the earliest stages of 1st metatarsophalangeal arthritis, there may be mild painless stiffness of the joint. At this point, the average toe wrestler may continue without any problems, however as the disease progresses, pain, reduction in motion and bony growth around the joint will increase. Initially, conservative measures such as padding and custom molded orthotics may provide adequate relief and even slow progression of joint deterioration. More severe stages of arthritis can require steroid injections to decrease inflammation. Eventually toe surgery can become a necessity. It is important to discuss your activity level and goals with your podiatrist when it comes time to select the best surgical procedure. Every foot is different and treatment programs must be individualized – a world class toe wrestler’s demands of their foot are going to be different from an individual who enjoys a more relaxed lifestyle!

Please visit www.ColumbusFoot.com for more tips for healthier and happier feet or call 614-885-3338 (FEET) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

Columbus Podiatry & Surgery has opened a new location in Gahanna, near Easton. Please call 614-476-3338 (FEET) for an appointment with a podiatrist in Gahanna, OH today.

Summer is in the air around Columbus, with warm temperatures and sunshine aplenty. However, with summer also comes more risky outdoor activities for kids and teens in the area. One teen from Arizona made national news this week after a risky activity lead to a serious foot injury. After jumping from the height of her house roof, instead of hitting pool water, her heels hit cement and she suffered fractures of both her heel bones.

After motor vehicle accidents, falls from a height cause some of the most devastating foot and ankle injuries. Severe fractures of the calcaneus, or heel bone and the bones comprising the ankle joint, the talus and tibia are difficult to treat and can be causes of pain years past the initial injury. The calcaneus is the most commonly fractured of the tarsal bones, which make up the midfoot and rearfoot. These fractures are very commonly intra-articular, meaning that they extend into the subtalar joint. Similarly, pilon fractures, or a fracture tibia that makes up the top of the ankle joint, are also intrarticular. Not all fractures require surgery, however if the fracture is comprised of many small pieces of bone or the pieces of bone are severely out of place, surgery will become necessary. In intra-articular fractures, bone surfaces that oppose each other in a joint must be restored as close to their original position as possible to minimize the development of painful arthritis later on. Bone healing may also be delayed, or may heal in an incorrect position if not properly treated. Such problems can result in difficulty walking or bearing any weight on the leg.

Problems also occur with the soft tissue surrounding bones in such severe injuries. After a fall from a roof, top of a skateboard ramp or other high structure, the foot will become very swollen, or edematous. Blisters may also develop from the tearing of skin layers. Any signs of swelling, redness, pain or tenderness in the foot should be a cause for concern after a trauma and reason to contact your podiatrist. Swelling can be a cause of continued pain and a reason to delay surgery until it has resolved. Special casts designed to decrease such edema are often applied after a trauma or surgery. So think twice before taking a leap this summer to prevent foot injuries that will disrupt future fun for months to come!

Please visit www.ColumbusFoot.com for more tips for healthier and happier feet or call 614-885-3338 (FEET) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

Columbus Podiatry & Surgery has opened a new location in Gahanna, near Easton. Please call 614-476-3338 (FEET) for an appointment with a podiatrist in Gahanna, OH today.

A recent study from the National Human Genome Research Institute confirmed that there are more types of fungus growing on the feet than many other locations in the body. Feet were found to have more fungus that even the nostril, elbow pit and crease between the thigh and groin. This research could explain why the feet and toenails seem to become infected by fungus much more frequently than anywhere else in the body.

Foot fungus infection or tinea pedis can have several different clinical manifestations. The most common form is known as interdigital tinea pedis, meaning that it occurs between the toes. Skin between the toes will often appear red, or white with moist skin that sloughs off, and with open cracks in the skin. Odor and itching may also be noted. A fungus species called Tricophyton rubrum most commonly causes interdigital, and most other types of tinea pedis, however other fungus or even bacteria may be contributing to the infection. Another very prevalent type of tinea pedis is the more commonly recognized form of chronic tinea pedis, or “Athlete’s foot”. This type of foot fungus infection may cause the feet to become itchy. The skin on the bottom of the foot will often appear red with overlying white scales. These two forms of tinea pedis are both commonly associated with the development of toenail fungus. Once fungus has invaded skin on the feet, it may penetrate the seal of the nail bed and migrate beneath the toenail. Lifting of the end of toenails, extreme thickening, debris under the nails, and color changes are all seen with toenail fungus, or onychomycosis.

When fungus occurs in thin skin, as in interdigital tinea pedis, topical anti-fungal creams or powders can penetrate into cells and kill the fungus. However antifungal medications cannot penetrate into nail or hair that has been infected. This fact combined with the new knowledge of the study showing that feet host from 80 to 100 different species of fungus can make treating a fungal infection, especially of the nails, very difficult. While some antifungal medications stall or slow fungus growth, others kill some species contributing to the infection. With around 100 species on the foot it can be difficult to be sure that the medication will treat the specific fungus causing the condition. It is for this reason that a nail or skin sample may need to be sent for testing to determine whether or not there is fungus present, and in some cases which species of fungus is present. Treatment for both toenail fungus and tinea pedis is very similar. Oral antifungal medications have had success in treating both toenail and skin fungal infection, however this treatment route has a number of drawbacks. Because oral medications are absorbed throughout the entire body, they will have more unwanted side effects in major organs compared to using only a topical treatment. Another option for toenail fungus is the PinPointe Foot Laser which is a non-systemic way of treating your toenails. This treatment method is quick, painless and has no systemic side effects. Once foot fungus has occurred it can often be difficult to completely eradicate, so it is important to take preventative measures to avoid developing a fungal infection. These measures include wearing sandals in public showers or around pools and good foot hygiene, which includes keeping feet clean and dry and not applying any lotions between the toes.

Please visit www.ColumbusFoot.com for more tips for healthier and happier feet or call 614-885-3338 (FEET) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

Columbus Podiatry & Surgery has opened a new location in Gahanna, near Easton. Please call 614-476-3338 (FEET) for an appointment with a podiatrist in Gahanna, OH today.

Last week was National Neuropathy Awareness Week across the United States, where one in 15 people are affected by peripheral neuropathy. In diabetes, which is the leading cause of peripheral neuropathy, damage occurs in what is called in a “stocking & glove distribution”. This means that nerve problems in diabetes begin in the feet, and subsequently affect the haTake Note of Neuropathy in Your Feetnds. In those with diabetes and neuropathy, good foot care is imperative maintaining foot function and avoiding wound and foot deformity development.

The best way to avoid and control the development of peripheral neuropathy, along with the many other health consequences associated with diabetes, is to control blood sugar. When blood glucose levels remain high, glucose is metabolized into substances called sorbitol and advanced glycation end products (AGEs). In nerves, sorbitol causes an increased amount of water to accumulate, resulting in swelling of the nerve. When AGEs accumulate in nerves, they are believed to cause the nerve to stiffen and be unable to glide and stretch as needed across joints. The combination of stiffening and swelling results in the nerve being compressed by surrounding tissue. With compression, blood supply is decreased and the symptoms of peripheral neuropathy begin. Early symptoms commonly felt include tingling, burning and numbness in the feet. These symptoms are often worse at night and may be severe enough to disrupt sleep.

With time and worsening of the neuropathy, the myelin sheath that surrounds the nerve and helps it to relay information about sensation and muscle movement decreases. This results in the loss of sensation in the feet that is extremely dangerous in individuals with diabetes. With sensation loss, the ability to protect feet from painful stimuli is lost, as well as the proprioceptive information that helps maintain balance. For this reason, regular checkups with your podiatrist are critical, as well as daily self-foot exams. Feet should be monitored for any cuts, abrasions, swelling redness, or changes in foot structure. Proper shoe fit is very important in individuals with sensory loss to avoid areas of repetitive irritation that could develop into an ulcer.

Please visit www.ColumbusFoot.com for more tips for healthier and happier feet or call 614-885-3338 (FEET) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

Columbus Podiatry & Surgery has opened a new location in Gahanna, near Easton. Please call 614-476-3338 (FEET) for an appointment with a podiatrist in Gahanna, OH today.

Active moms around Ohio celebrated Mother’s Day in their own way this past Sunday. Some moms chose to spend the day on their feet at events like the Greater Columbus Ladies Only 5K Run in Grove City, Ohio. Other moms went for a bit more pampering for their toes, with spa treatments or kicking their heels up on the couch!

While pedicures are always a popular gift, there are many varieties of foot and ankle pampering to choose from. It is always important to be careful when visiting even a highly regarded nail salon. Be sure to ask that the foot bath has been disinfected in between each use. Bacteria grow in the moist areas of an improperly cleaned foot bath. It is also for this reason that pedicures should be avoided if an individual has any cuts or scrapes on their feet or legs. Even a small nick from shaving can be enough for bacteria to enter the body and cause serious infection. Nails should be squared in shape rather than rounded to prevent the development of painful ingrown toenails. Ingrown nails develop with curved nails that begin to grow out and dig into the skin folds in front of the nail, causing pain and irritation. In some cases, ingrown nails can also become infected. For those with a fungal toenail infection, the pedicurist may be able to help restore nails to a more normal thickness, but polishing fungal nails may do more harm than good. By painting fungal toenails (unless it is an antifungal nail polish!), the fungus is trapped under the polish and can flourish in the warm dark environment. One gift for moms with fungal toenails would be to treat them to a session of the PinPoint Foot Laser that is a painless therapy to effectively clear up fungal nails.

For active moms, who may have been gifted athletic shoe store gift cards or race entries, foot health should be a major consideration when using these gifts. Whether entering a race or trying a new shoe style, moderation is imperative. If the gift card is to be used towards new barefoot style of running shoes, mileage should initially be kept very low in the shoes to give the foot time to adjust. It is also crucial that moms and anyone else interested in trying out barefoot running educates themselves on the proper form required when wearing the “barefoot” or “minimalist” style of sneakers. Overtraining initially with improper form can easily lead to the development of foot injuries including stress fractures and tendonitis.

Regardless of how you chose to show your appreciation for mom, hopefully it involved giving her the day to relax and take care of her feet in any way she chose!

Please visit www.ColumbusFoot.com for more tips for healthier and happier feet or call 614-885-3338 (FEET) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

Columbus Podiatry & Surgery has opened a new location in Gahanna, near Easton. Please call 614-476-3338 (FEET) for an appointment with a podiatrist in Gahanna, OH today.

Nurses should be celebrated year round for their contributions to the health and well-being of patients, and this week Nurses Week has health care centers acknowledging those contributions. In the care of foot and ankle conditions, nurses often play a huge role in following through with treatment plans. Many patients with chronic wounds or ulcers on their feet require the assistance of a home nurse to aid in dressing changes and care in the interval between visits to the podiatrist.

The first goal in the treatment of a chronic wound is to identify the cause of the wound’s inability to heal. There are three phases of healing that all wounds must go as they close: the inflammatory, proliferative and remodeling phase. In these phases bacteria and dead tissue are first cleared from the wound, then skin cells and blood supply are restored, and finally strength is developed in the healing tissue. When one of the components needed to proceed through of any of these phases is lacking, healing becomes stalled. Infection, poor blood flow, excessive pressure and poor nutrition are a few of the major factors that can cause impaired healing. Infection is treated with antibiotics and physically removing the infection from the wound by debridement. Poor blood supply often requires a visit to a vascular specialist who can “unclog” or “reroute” blood flow so that it may reach the wound area. Poor blood return, or venous insufficiency, is most often treated with pressure dressings that will stop blood from pooling in the legs. Pressure must be addressed by offloading a wound with padding, and often special shoe gear. In individuals with diabetes, excessive pressure that occurs when there is neuropathy, or lack of sensation, causes a higher risk of wound development and difficulty healing.

Dressing a wound contributes to the healing process by aiding in the removal of the harmful factors that impair healing, activating healing and adding cells and molecules that will improve healing. The ideal moist wound environment will promote skin and blood vessel cell growth, promote the removal of bacteria and dead tissue by cells in the body and impede the development of further dead and unhealthy tissue. Dressings will also protect the wound from trauma and bacteria. In a wound in which there is an excessive amount of drainage, frequent dressing changes are necessary to attain the ideal healing environment. Nurses and home health aides play a key role in assisting patients at home in applying dressings as needed between visits to their podiatrist.

Please visit www.ColumbusFoot.com for more tips for healthier and happier feet or call 614-885-3338 (FEET) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

Columbus Podiatry & Surgery has opened a new location in Gahanna, near Easton. Please call 614-476-3338 (FEET) for an appointment with a podiatrist in Gahanna, OH today.

Beginning at the end of March, the Center for Disease Control released its second set of “in your face” style of ads highlighting the terrifying consequences of smoking cigarettes. The ads running throughout April and May show people whose lives have been personally affected by smoking. One individual prominently featured in the ads, a former smoker named Bill, unfortunately was forced to undergo a below knee amputation after the combination of smoking and diabetes caused severe disease in his lower extremity. Smoking has a huge impact in the health of the foot and ankle, much like it does elsewhere in the body.

Smoking releases a molecule known as norepinephrine, which triggers blood vessels to constrict, or narrow. When the already small vessels in the foot constrict, oxygen and the cells that fight infection and aid in healing are unable to reach tissues. Each cigarette smoked has been shown to cause oxygen levels to fall and remain low for 30 to 50 minutes. This is of great concern in those with a foot wound or incision after surgery, in which blood flow and oxygen are vital to skin healing.

Each cigarette contains more than 4,000 chemicals. Some of these chemicals include carbon monoxide, methanol (which is found in rocket fuel), ammonia, and nicotine. Nicotine has been shown to decrease the molecules that are responsible for growth of new blood vessels and development of osteoblasts, or bone building cells. Carbon monoxide further contributes to the decrease in tissue oxygen caused by vessel constriction, by taking oxygen away from the molecule it is normally transported in in the blood. It is for these reasons that quitting smoking is imperative for individuals with foot problems. Studies have shown that there is a 2.7 times higher risk of bone not healing in smokers compared to non-smokers undergoing foot surgery. Prior to foot surgery involving bone, smoking should be stopped at least 6 weeks prior to the procedure if possible.

In individuals with diabetes or other disorders affecting their blood vessels, smoking is even more dangerous. Pressure ulcers develop when sensation is diminished and the normal feeling of pain associated with a wound is not present. Tissue healing is impaired and there is a heightened risk of infection developing. Combined with smoking, such risks are furthered increased. Individuals with diabetes who notice a foot wound, whether they are smokers or not, should contact their podiatrist immediately. Early treatment can prevent infection and worsening of the wound that can potentially lead to a need for amputation. Bill’s story in the smoking ads is a scary one, but by sharing it he may be able to prevent others from suffering a similar fate of amputation.

Please visit www.ColumbusFoot.com for more information or call 614-885-3338 (FEET) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

Columbus Podiatry & Surgery has opened a new location in Gahanna, near Easton. Please call 614-476-3338 (FEET) for an appointment with a podiatrist in Gahanna, OH today.