Posts for: April, 2022
Ever had a day when you come home from a long day’s work where you’re standing for long periods of time in uncomfortable shoes and notice what appears to be a skin bubble on a sore part of your feet? This is known as a blister.
A blister essentially a fluid-filled pocket in the skin. By and large blisters are due to the excessive friction or abrasive force which breaks down the layers of the skin causing fluid to fill it. Though they can form from ill-fitted shoes, whether they may be too tight or too loose, they can also form when individuals walk, stand or run for an extended length of time. The most common areas on your feet where you might find a blister are usually areas where a bony prominence or protuberance makes contact with either the inside of your shoes or the ground itself. This includes areas like your bunion, toes, or top of the foot.
If you’re someone who tends to sweat a long in your feet particularly when having shoes on, this can cause blisters to form more easily. This is why many athletes who are training for a large portion of their day and who are sweating in their shoes can form blisters after they’re done with their regiment. Though they may feel uncomfortable, blisters typically resolve on their own when the feet are given a bit of rest, ice, applying an antiseptic, change in shoegear and being checked by a podiatrist.
Blisters can also sporadically form on your legs if you have any swelling in your legs from any venous compromise issues, particularly if you lead a sedentary lifestyle. This can happen even if nothing seems to be rubbing on your legs because these types of blisters are due to the high fluid pressure in the legs. Seeing your podiatrist as well as a vascular specialist to manage the swelling in your legs is definitely needed. Other causes may include an insect bite, a burn or an infection in the skin.
So the next time you notice a blister, follow these steps:
1. Wash and cleanse your feet. This gets rid of any sweat along with any bacteria or fungus that may be residing on the surface of your skin.
2. Apply betadine on the region and cover with a bandaid. Betadine works as an antiseptic which can help it to kill any bacteria in the area as well as it helps to dry the area out.
3. Apply moleskin on the inside of the shoe that is causing the rubbing on the skin. Moleskin is a heavy cotton fabric with an adhesive backing that can be applied to areas to reduce friction and irritation to the skin.
4. Change your shoes. Sometimes it’s the shoes that can cause some wear and tear on your feet, whether they are old or new. Something as simple as changing your shoes to something more accommodative or soft may do the trick. Shoes that are also the correct length, width and toe box height are also factors.
5. DO NOT try to pop it! Some sources will say to simply pop the blister with a needle when at home. DON’T DO THIS. This can potentially lead to a serious infection and wound care especially if you’re diabetic. If the blister needs to be deflated, it is strongly recommended it is done by a podiatrist in a clinical office setting with proper instruments and after care can be given. Even if it pops before you see a podiatrist, follow the first two steps and still seek help by a professional before it gets worse.
6. I’ve done all these steps. If you’ve exhausted these steps but notice the blister getting worse, becoming more red or notice new blisters forming, then make an appointment with your local podiatrist for assessment and evaluation.
If you need further advice on what types of shoes are good for your feet as well as how they should fit, please visit our other informative blog posts by Dr. Evan Vieira and Dr. Arden Smith in the links below:
Serious foot complications can be part of diabetes. For instance, nerve damage – or neuropathy – is a loss of sensation that can occur due to uncontrolled diabetes.
Neuropathy can then result in calluses, which can lead to diabetic ulcers. In severe cases, this can also cause foot infections that may even lead to amputations if not managed in a timely manner.
Other foot problems caused by diabetes can include:
Hammertoe Deformity‘s due to a neuropathy induced imbalance with tendon and muscle.
Poor circulation that may cause irreversible damage such as gangrene
Skin disorders like cracked skin or fungal infections due to an immunocompromised state.
If you are a diabetic and suspect any foot issue, it is imperative that you call one of our Advanced Podiatry offices of Manhasset, Huntington, Maspeth, Plainview, Coram, Williston Park, or Mineola. And one of our award-winning, expert podiatrists will be happy to evaluate your problem and discuss the best treatment options with you.
Remember, as Benjamin Franklin said, "an once of prevention is worth a pound of cure", so a biannual diabetic foot evaluation by one of our expert Advanced Podiatry podiatrists is prudent.
Have you ever noticed your child walking around on his/her tiptoes and wondered if it’s a real medical condition needing medical treatment or if it’s “just a phase”? Or have you ever noticed as an adult how your walking pattern causes your heel to lift off before your other foot has made contact on the ground? This is commonly known as toe-walking or having an equinus gait.
What Is Toe-Walking?
Despite popular belief, toe-walking is not a condition strictly involving children. It can be found in adults as well, though it is more common in children. Toe-walking is traditionally defined as the way in which the patient walks on their “tiptoes” or “balls of their feet” with their heels lifted off the ground, unlike a normal heel to toe gait. This condition is also known as an equinus gait pattern and it is typically regarded as hereditary trait wherein the Achilles tendon is shorter or tighter than normal. There are several ways to spot and treat this condition. And no, simply telling your child to “stop walking that way” isn't going to work.
Is This Normal?
A very common question is “is toe-walking normal?”. Yes, it is normal to see your child toe-walking particularly in the early stages when they are 3 years of age or younger. However if the child is above the age of 3 and they do not display a normal heel to toe gait pattern, this can be an early sign of toe-walking. There are a few reasons why this might happen. First and foremost would be that there is a strong correlation with a hereditary component. Underlying neurological conditions such as cerebral palsy, autism, or even pathologies/injuries related to the posterior muscle group can be factors.
Are There Different Types?
There are 3 main types of this deformity: uncompensated, fully compensated, and partially compensated:
- Uncompensated is the most noticeable and recognizable. The tension force of the tight achilles is not being compensated or counteracted by other joints or tendons in the foot. This is when the person walks on the balls of their feet without the heels ever contacting the floor as they walk.
- Fully compensated usually demonstrates a greater arch collapse due to the surrounding joints compensating for the tight Achilles. Though this type of compensation does not produce a bouncy gait and the manner in which the person walks appears to be normal, this is in fact the worse type. The ligaments holding the bone structure together are more laxed leading to a lower arch. A collapsed or flattened arch translates to inadequate and inefficient push off of the great toe, producing a slower cadence. This means patients in this category quickly fatigue and are likely to abstain from physical activities such as exercise and sports.
- Partially compensated is a milder form of the fully compensated foot. It normally is associated with a “bouncy” gait. The contracting force only partially affects neighboring joints and ligaments which means the heel lowers to the ground more than if it were uncompensated but not enough to produce a stable heel to toe gait.
What Are The Available Treatments?
Physical therapy and stretching exercises can help to gently and serially stretch the tight tendon over time. Certain leg braces such as an AFO or night splints can be utilized as well to lengthen the tendon, though these methods rely heavily on patient compliance. Serial casting with below knee casts can be done if the toe walking gait is diagnosed at an early age. Botox injections can also help stretch the tight muscle complex, though it is rare. When conservative measures fail, surgical tendon lengthening of the posterior muscle compartment of the leg can assist in achieving a more plantigrade foot. It is noteworthy however that if the primary cause for the gait is related to cerebral palsy, autism or other neurological issues, these issues need to be examined and options need to be evaluated in tandem with a neurological consult.