By Dr. Evan Vieira
March 19, 2018
Category: Foot Tips
Tags: Basketball   Foot Care   foot injury  


March Madness is here!  One of the most exciting times of year in sports.  Basketball is an exciting, high energy, fast paced sport.  Constant lead changes and fiercely competitive college athletes make the NCAA tournament amazing.  

Basketball is very often synonymous with lower extremity and foot injuries.  The nature of the sport puts a lot of stress on the feet and ankles.  Sprains and fractures are unfortunately a common injury for these types of athletes.  A sprain, or tearing of a ligament is often treated with a. period of immobilization, but can require surgery.  The same goes for fractures of the feet.  
We here at advanced podiatry are experts in all types of lower extremity injuries.  So. if you find yourself sidelined we can get you back on the court. Go Orange!
By Dr Joseph DiStefano
February 26, 2018
Category: Foot Care
Tags: Foot Care   frostbite  


Well, the weather outside isn’t exactly frightful. It’s been downright beautiful actually, and I’ll take it any day.

Watching the Olympics and seeing people bundled up from the frigid temperatures brings a very common aliment to light. Frostbite is actually much more common than is thought. It’s not just the Alaskan dogsledders and Antarctica explorers that get it. When the temperature is 0 degrees Fahrenheit with a 15 degree wind speed, the result is a wind chill of -19 degrees. At this temperature, bare skin will start to develop frostbite in about 30 minutes. It’s harder to know how fast covered skin will get frostbite, but be aware that it can and does happen.

Since the extremities are further away from the core of the body, specifically the hands and feet, they are usually the first areas affected by frostbite. Anyone who has been in a snowball fight without gloves is familiar with the onset of symptoms. Red, sore and stiff is the first sign of frostnip, which is not frostbite, but is the beginning in the progression of the condition. Usually sticking your hands in your pockets or moving your toes around will be enough to reverse frostnip, but if the cold continues, the area will progress to frostbite.

There are three stages of frostbite, which correspond to how deep the cold penetrates. In the early stages, the skin will be white and you will likely feel pins and needles in addition to a burning or stinging feeling. Next, blisters can form and the skin becomes hard and shiny. In the advanced stages, the outer skin will turn blue or black and the pain decreases due to damage to nerve tissue.  The faster you can get out of the cold and warm the areas, the better your chances are to reduce permanent damage.

Often times, patients will come to the office and report they frequently get cold, pale extremities. Sometimes the tips of the fingers or toes will get bright red even though the rest of the hand or foot is cold and white. This is referred to as Rayanauds, sometimes brought about by previous exposure to frostbite. The best way to be sure is to be evaluated by a podiatrist. And don’t forget to layer up!

By Dr. Quynh P. Lee
February 25, 2018
Category: Foot Tips
Tags: Olympics  

Have you been following the 23rd Winter Olympic games in Pyeongchang, South Korea? Are you impressed and enthralled by the skill and passion of the athletes in the games? Do you know that even the toughest and most well trained athletes in the world are plagued by foot issues?


Adam Rippon, a U.S. Figure Skater sprained his left ankle and fractured his fifth metatarsal bone in his foot just before the 2017 U.S. Figure Skating Championships. He was warming up his legs by jumping up and down and that is how the injury occured. It is very common after a serious ankle sprain that one can also fracture their fifth metatarsal bone due to the mechanism of injury. Rippon blames “not getting enough nutrients” for his injury. He went on to finish fourth at the 2018 U.S Nations and is now at the 2018 Winter Olympics!


Katie Ormerod, is a snowboarder from Great Britain who fractured her right heel during warm-ups before the start of the 2018 Winter Olympics during a training session in Seoul. On her Facebook page, she states she broke her heel bone in two places and required surgery. She recently updated her fans that she needs additional surgeries because she almost had an open fracture due to the bone nearly piercing her skin and as a result, the skin on her heel is necrotic. Healing from this type of injury can take several months with cast immobilization after the surgery and with gradual rehabilitation.


American ice dancer, Madison Chock has been dealing with a chronic foot issue “all season” that most recently flared up right before her and her partner took the ice in their first Olympic routine. She explained to the press that she has an osteochondral lesion in her foot- “there’s a loose bone fragment that’s in the joint that just is being held by cartilage right now,” she said. She later said she was going to ice extra and do physical therapy.


As you can see, sports and exercise is great for you but can be extremely demanding on a competitive level. Remember to always wear proper shoe gear (even sport appropriate shoe gear!) and to warm up. If you feel you or a loved one may have a sports related injury and would like an examination please give us a call so that we may make you an appointment!


Enjoy the rest of the 2018 Winter Olympics!!

By Dr Joseph DiStefano
December 15, 2017
Category: Orthotics
Tags: Foot Care   Orthotics  


I should let you know Mr or Mrs reader, in the business of feet, there is no such thing as a perfect foot. I have yet to come across a person who has never had foot pain (or at least discomfort) of some sort at some point in time. It’s the nature of the body part.

There is a unique chain of events that occur in the lower extremities in order for us to move, groove and shake to get us to where we’re getting. If you remember the rhyme, the hip bone is connected to the leg bone, the leg bone is connected to the knee bone, and all the way down to the foot. It all ends in the foot. When the stress of holding and supporting the entire body becomes too much for the foot, things start to break down.

Most injuries, no matter where they are, will heal with a little time. Problems with the feet present a different challenge when a musculoskeletal injury occurs. Bend a finger the wrong way and you can use the other hand for a few weeks. Hurt your shoulder? A sling and some advil will fix you up. Chronic issues in the lower extremities, especially the feet, are more difficult to treat because very few humans walk on their hands. Every step taken will cause further pain and swelling once an issue arises in the foot.

The best way we can control the mechanics of the foot is with a custom orthotic, fabricated for the individual. I’m sure you’ve seen similar products on the shelves of most shoe stores, but: a) these aren’t medical devices, and b) these aren’t customized to the anatomic contours of the patient. To properly support the foot, an orthotic needs to be made of materials strong enough to reposition the foot, and padded well enough to make the device comfortable.

Through my extensive training in sports medicine and experience rehabilitating a wide variety of musculoskeletal injuries, I have seen many different formulations of orthotic devices. I say without reservation that those offered by Advanced Podiatry are far superior to most I’ve seen. They will talor the device to suit the patient’s lifestyle and shoe choices to allow for the best combination of function and fit. 

By Dr. Evan Vieira
December 04, 2017
Category: Foot Injury
Tags: Fracture   Lisfranc fracture  


A Lisfranc fracture is a common injury of the foot, usually suffered in a high impact fashion.  This causes the 1st and 2nd metatarsal or long bones of the foot to separate.  A Lisfranc injury is sometimes complicated to treat as this is one of the most important supportive ligaments to the structure of the foot.  

This type of injury can require surgery, but with some new advances in technology we have been able too achieve amazing results with the use of a period of immobilization and external bone stimulation devices. Above are images of a female patient who suffered such an injury.  As you can see the bottom of the 2nd metatarsi bone is clearly broken, however the next image shoes it healed in only about 5 weeks!  
This is just one example, but if you find yourself with a foot injury we are here for you too!

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Advanced Podiatry of Manhasset at the Americana

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