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What are Achilles Tendon Injuries

The Achilles tendon is the strongest tendon in the human body. Its purpose is to connect the lower leg muscles and calf to the heel of the foot. This tendon is responsible for facilitating all types of movement, like walking and running. Since this tendon provides an enormous amount of mobility to an individual, any injuries inflicted to this tissue should be immediately brought up with a physician to prevent further damage.

The most common injuries that can trouble the Achilles tendon are tendon ruptures and Achilles tendinitis. Achilles tendinitis is the milder of the two injuries and can be recognized by the following symptoms: inflammation, dull to severe pain, an increased flow of blood to the tendon, thickening of the tendon, and slower movement time. Tendinitis can be treated via several methods and is often diagnosed by an MRI.

An Achilles tendon rupture is trickier to heal, and is by far the most painful injury. It is caused by the tendon ripping or completely snapping. The results are immediate and absolutely devastating, and will render the patient immobile. If a rupture or tear occurs, operative and non-operative methods are available. Once the treatment begins, depending on the severity of the injury, recovery time for these types of issues can take up to a year.

Simple preventative measures can be taken as a means to avoid both injuries. Prior to any movement, taking a few minutes to stretch out the tendon is a great way to stimulate the tissue. Calf raises, squats, leg curls, leg extensions, leg raises, lunges, and leg presses are all suggested ways to help strengthen the lower legs and promote Achilles tendon health.

Many problems arise among athletes and people who overexert themselves while exercising or who do not properly warm up before beginning an activity. Proper, comfortable shoes that fit correctly can also decrease tendon injuries. Some professionals also suggest that when exercising, you should make sure that the floor you are on is cushioned or has a mat, as this will relieve pressure on the heels. As always, a healthy diet will also increase tendon health.

It is very important to seek out a podiatrist if you believe you have an injury in the Achilles region, because further damage could result in severe complications that would make being mobile difficult, if not impossible.

 

Heel Pain

Heel pain is a stressful condition that effects day to day activities. Running and walking causes stress on the heel because the heel is the part of the foot that hits the ground first. This means that the heel is taking on your entire weight. Diagnosis and treatments for heel pain can be easily found through your podiatrist.

One of the main causes of heel pain is a condition known as plantar fasciitis. The plantar fascia is a band of tissue that extends along the bottom of the foot, from the toe to the bottom of the heel. A rip or tear in this ligament can cause inflammation of these tissues, resulting in heel pain. People who do not wear proper fitting shoes are often at risk of developing problems such as plantar fasciitis. Unnecessary stress from ill fitting shoes, weight change, excessive running, and wearing non-supportive shoes on hard surfaces are all causes of plantar fasciitis.

Achilles tendonitis is another cause of heel pain. Similar to plantar fasciitis, inflammation of the Achilles tendon will cause heel pain due to stress fractures and muscle tearing. A lack of flexibility of the ankle and heel is an indicator of Achilles tendonitis. If left untreated, this condition can lead to plantar fasciitis and cause even more pain on your heel.

A third cause of heel pain is a heel spur. A heel spur occurs when the tissues of the plantar fascia undergo a great deal of stress, leading to a separation of the ligament from the heel bone entirely. This results in a pointed fragment of bone on the ball of the foot, known as a heel spur.

Treatments for heel pain are easy and effective as long as problems are addressed quickly. The most common solution is simply taking stress off the feet, particularly off of the heel. This will ease the pain and allow the tendons and ligaments to relax. In the case of both plantar fasciitis and Achilles tendonitis, icing will reduce swelling of any part of the foot and anti-inflammatory medication is highly recommended. Properly fitting your shoes and wearing heel pads or comfort insoles will also reduce the risk of developing heel pain. Stretching before and after exercises such as running will help the foot muscles prepare for stress and lower the chances of inflammatory pain. In extreme cases, relieving heel   pain might require surgery. Always make sure to discuss these symptoms and treatment options with your podiatrist to keep yourself active and pain free.



Hyperhidrosis of the Feet

Hyperhidrosis of the feet, also termed plantar hyperhidrosis, is characterized by excessive sweating of the feet that is not onset by any cause, such as exercise, fever, or anxiety. Most people suffering from hyperhidrosis of the feet also experience hyperhidrosis of the hands, or palmar hyperhidrosis. Approximately 1-2% of Americans suffer from this disorder.

Sweating is a healthy process utilized by the body in order to cool itself and maintain a proper internal temperature, which is controlled by the sympathetic nervous system. In individuals with hyperhidrosis, the sympathetic nervous system works in "overdrive", producing far more sweat than is actually needed.

Plantar hyperhidrosis is considered primary hyperhidrosis. Secondary hyperhidrosis refers to excessive sweating that occurs in an area other than the feet, hands, or armpits, and this indicates that is related to another medical condition, such as menopause, hyperthyroidism, or Parkinson's disease.

The symptoms of hyperhidrosis of the feet can include foot odor, athlete's foot, infections, and blisters. Because of the continual moisture, shoes and socks can rot which creates an additional foul odor and can ruin the materials, requiring shoes and socks to be replaced frequently. In addition to the physical symptoms, emotional health is often affected as this disorder can be very embarrassing.

If left untreated, hyperhidrosis will usually persist throughout an individual's life. However, there are several treatment options available. A common first approach to treating hyperhidrosis of the feet is a topical ointment. Aluminum chloride, an ingredient found in antiperspirants, can be effective at treating hyperhidrosis if used in high concentration and applied to the foot daily. Some individuals can experience relief this way, while others encounter extreme irritation and are unable to use the product. Another procedure is the use of Botulinum Toxin A, commonly referred to as Botox. This is injected directly into the foot, and is effective at minimizing the sweat glands in the injected area. These injections must be repeated every 4 to 9 months.

If these treatments are ineffective, oral prescription medications may be taken in an effort to alleviate the symptoms. Again, some will experience relief while others do not. Going barefoot reportedly provides relief for most sufferers.

A final approach to combating hyperhidrosis of the feet is through surgery. Surgery has been less successful on patients with plantar hyperhidrosis than on those with palmar hyperhidrosis. It is only recommended when sweating is severe and other treatments have failed to work. This kind of surgery usually involves going into the central nervous system, and cutting nerves to stop the transmission of signals telling the foot to sweat.



Barefoot Running

A new trend in running and jogging has popped up recently, called barefoot running. Barefoot running is a popular and growing trend that is just what it sounds – running without shoes. Before deciding to do any running without shoes, it's best to understand how this kind of running affects the feet.

Running without shoes changes the motion of running. Most running is done by landing on the heel of the feet. Running barefoot requires a different way of running; in a barefoot stride landing is done on the front part of the feet. Because of this, the impact shifts from the heels to the front feet. Runners also shorten their strides to create a softer landing.

Running barefoot does have its advantages. When running and landing on the front feet, the impact on the feet and ankle is reduced, which may reduce the incidence of stress injuries. It strengthens muscles in the feet, and also strengthens muscles in the ankles and lower legs that aren't usually worked. Overall balance of the body is improved and there is greater sensory input from the feet to the rest of the body, making overall position and motion less stressful on the body. It has been found that in countries in which some of the population regularly wear shoes and some do not, numbers of foot and ankle injuries are much higher in those who wear shoes.

People hearing about barefoot running for the first time are skeptical about it, and there are good reasons for skepticism. Running barefoot certainly has its drawbacks, the obvious being no protection of the feet when running. This makes it likely that when runners land on sharp or rough objects,  scrapes, bruises, and cuts on feet will result. Blisters will form when beginning this kind of running especially, you may have plantar fascia problems. Landing on the front feet constantly also increases the risk of getting Achilles tendonitis.

So what can runners do to make barefoot running safe? It’s best to make a slow transition from running shoes to barefoot running. The body is used to wearing shoes so to slowly transition to bare feet, start by walking barefoot for a distance and then increase walking distance. Once the feet begin to adjust, try walking and then jogging and gradually increase the distance. If you have foot problems talk to the doctor first before attempting barefoot running. When starting out, it may also be helpful to begin by running on pavement or other consistent surfaces to avoid sharp or rough objects. Minimalist running shoes may also be an option, as they allow for many of the benefits of barefoot running while also protecting the feet from cuts and scrapes.


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Dr. Mayer Salama and Dr. Daniel Salama
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Trenton, MI 48183 -(734) 676-4664

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