Sarasota Foot Care Center

Special Report on Bunions

2012-01-27T10:10:00.000-08:00

Although bunions are a common foot deformity, there are many misconceptions about them. Many people may unnecessarily suffer the pain of bunions for years before seeking treatment.

What is a Bunion?
Bunions (hallux valgus) are often described as a bump on the side of the big toe. But a bunion is more than that. The visible bump actually reflects changes in the bony framework of the front part of the foot. With a bunion, the big toe leans toward the second toe, rather than pointing straight ahead. This throws the bones out of alignment, producing the bunion's "bump." Bunions are a progressive disorder. They begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the characteristic bump, which continues to become increasingly prominent. Usually the symptoms of bunions appear at later stages, although some people never have symptoms.

What Causes a Bunion?
Bunions are most often caused by an inherited faulty mechanical structure of the foot. It is not the bunion itself that is inherited, but certain foot types that make a person prone to developing a bunion. Although wearing shoes that crowd the toes won't actually cause bunions in the first place, it sometimes makes the deformity get progressively worse. That means you may experience symptoms sooner.

Bunion Symptoms
Symptoms occur most often when wearing shoes that crowd the toes -- shoes with a tight toe box or high heels. This may explain why women are more likely to have symptoms than men. In addition, spending long periods of time on your feet can aggravate the symptoms of bunions.

Symptoms that occur at the site of the bunion may include:
• Pain or soreness
• Inflammation and redness
• A burning sensation
• Perhaps some numbness
• Other conditions which may appear with bunions include calluses on the big toe, sores between the toes, ingrown toenail, and restricted motion of the toe.

Diagnosis
Bunions are readily apparent -- you can see the prominence at the base of the big toe or side of the foot. However, to fully evaluate your condition, the foot and ankle surgeon may take X-rays to determine the degree of the deformity and assess the changes that have occurred. Because bunions are progressive, they don't go away, and will usually get worse over time. But not all cases are alike--some bunions progress more rapidly than others. Once your foot and ankle surgeon has evaluated your particular case, a treatment plan can be developed that is suited to your needs.

Treatment
Sometimes observation of the bunion is all that's needed. A periodic office evaluation and X-ray examination can determine if your bunion deformity is advancing, thereby reducing your chance of irreversible damage to the joint. In many other cases, however, some type of treatment is needed.
Early treatments are aimed at easing the pain of bunions, but they won't reverse the deformity itself. These options include:
• Changes in footwear: Wearing the right kind of shoes is very important. Choose shoes that have a wide toe box and forgo those with pointed toes or high heels which may aggravate the condition.
• Padding: Pads placed over the area of the bunion can help minimize pain. You can get bunion pads from your foot and ankle surgeon or purchase them at a drug store.
• Activity modification: Avoid activity that causes bunion pain, including standing for long periods of time.
• Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help to relieve pain.
• Icing: Applying an ice pack several times a day helps reduce inflammation and pain.
• Injection therapy: Although rarely used in bunion treatment, injections of corticosteroids may be useful in treating the inflamed bursa (fluid-filled sac located in a joint) sometimes seen with bunions.
• Orthotic devices: In some cases, custom orthotic devices may be provided by the foot and ankle surgeon.

When is Surgery Needed?
When the pain of a bunion interferes with daily activities, it's time to discuss surgical options with your foot and ankle surgeon. Together you can decide if surgery is best for you.Recent advances in surgical techniques have led to a very high success rate in treating bunions. A variety of surgical procedures are performed to treat bunions. The procedures are designed to remove the "bump" of bone, correct the changes in the bony structure of the foot, as well as correct soft tissue changes that may also have occurred. The goal of these corrections is the elimination of pain.

In selecting the procedure or combination of procedures for your particular case, the surgeon will take into consideration the extent of your deformity based on the X-ray findings, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
sarasotafootcarecenter.com

Special Report on Hammertoes

2012-01-17T11:28:00.000-08:00

What is Hammertoe?

Hammertoe is a contracture--or bending--of one or both joints of the second, third, fourth, or fifth (little) toes. This abnormal bending can put pressure on the toe when wearing shoes, causing problems to develop. Common symptoms of hammertoes include:
• Pain or irritation of the affected toe when wearing shoes.
• Corns (a buildup of skin) on the top, side, or end of the toe, or between two toes. Corns are caused by constant friction against the shoe. They may be soft or hard, depending upon their location.
• Calluses (another type of skin buildup) on the bottom of the toe or on the ball of the foot.
Corns and calluses can be painful and make it difficult to find a comfortable shoe. But even without corns and calluses, hammertoes can cause pain because the joint itself may become dislocated. Hammertoes usually start out as mild deformities and get progressively worse over time. In the earlier stages, hammertoes are flexible and the symptoms can often be managed with noninvasive measures. But if left untreated, hammertoes can become more rigid and will not respond to non-surgical treatment. Corns are more likely to develop as time goes on--and corns never really go away, even after trimming. In more severe cases of hammertoe, open sores may form. Because of the progressive nature of hammertoes, they should receive early attention. Hammertoes never get better without some kind of intervention.
What Causes Hammertoe?
The most common cause of hammertoe is a muscle/tendon imbalance. This imbalance, which leads to a bending of the toe, results from mechanical (structural) changes in the foot that occur over time in some people. Hammertoes are often aggravated by shoes that don't fit properly -- for example, shoes that crowd the toes. And in some cases, ill-fitting shoes can actually cause the contracture that defines hammertoe. For example, a hammertoe may develop if a toe is too long and is forced into a cramped position when a tight shoe is worn. Occasionally, hammertoe is caused by some kind of trauma, such as a previously broken toe. In some people, hammertoes are inherited.
Treatment: Non-Surgical Approaches
There are a variety of treatment options for hammertoe. The treatment your foot and ankle surgeon selects will depend upon the severity of your hammertoe and other factors.
A number of non-surgical measures can be undertaken:
• Trimming corns and calluses. This should be done by a healthcare professional. Never attempt to do this yourself, because you run the risk of cuts and infection. Your foot and ankle surgeon knows the proper way to trim corns to bring you the greatest benefit.
• Padding corns and calluses. Your foot and ankle surgeon can provide or prescribe pads designed to shield corns from irritation. If you want to try over-the-counter pads, avoid the medicated types. Medicated pads are generally not recommended because they may contain a small amount of acid that can be harmful. Consult your foot and ankle surgeon about this option.
• Changes in shoewear. Avoid shoes with pointed toes, shoes that are too short, or shoes with high heels -- conditions that can force your toe against the front of the shoe. Instead, choose comfortable shoes with a deep, roomy toe box and heels no higher than two inches.
• Orthotic devices. A custom orthotic device placed in your shoe may help control the muscle/tendon imbalance.
• Injection therapy. Corticosteroid injections are sometimes used to ease pain and inflammation caused by hammertoe.
• Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are often prescribed to reduce pain and inflammation.
• Splinting/strapping. Splints or small straps may be applied by the foot and ankle surgeon to realign the bent toe.
When is Surgery Needed?
In some cases, usually when the hammertoe has become more rigid, surgery is needed to relieve the pain and discomfort caused by the deformity. Your foot and ankle surgeon will discuss the options and select a plan tailored to your needs. Among other concerns, he or she will take into consideration the type of shoes you want to wear, the number of toes involved, your activity level, your age, and the severity of the hammertoe.
The most common surgical procedure performed to correct a hammertoe is called arthroplasty. In this procedure, the surgeon removes a small section of the bone from the affected joint.
Another surgical option is arthrodesis, which is usually reserved for more rigid toes or severe cases, such as when there are multiple joints or toes involved. Arthrodesis is a procedure that involves a fusing of a small joint in the toe to straighten it. A pin or other small fixation device is typically used to hold the toe in position while the bones are healing.
It is possible that a patient may require other procedures, as well -- especially when the hammertoe condition is severe. Some of these procedures include skin wedging (the removal of wedges of skin), tendon/muscle rebalancing or lengthening, small tendon transfers, or relocation of surrounding joints.
Often patients with hammertoe have bunions or other foot deformities corrected at the same time. The length of the recovery period will vary, depending on the procedure or procedures performed.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
www.sarasotafootcarecenter.com

Special Report on Neuromas

2012-01-17T11:26:00.000-08:00

What is a Neuroma?

A neuroma is a thickening of nerve tissue that may develop in various parts of the body. The most common neuroma in the foot is a Morton's neuroma, which occurs at the base of the third and fourth toes. It is sometimes referred to as an intermetatarsal neuroma. "Intermetatarsal" describes its location - in the ball of the foot between the metatarsal bones (the bones extending from the toes to the midfoot). Neuromas may also occur in other locations in the foot. The thickening, or enlargement, of the nerve that defines a neuroma is the result of compression and irritation of the nerve. This compression creates swelling of the nerve, eventually leading to permanent nerve damage.
Symptoms of a Morton's Neuroma
If you have a Morton''s neuroma, you will probably have one or more of these symptoms where the nerve damage in occurring:
• Tingling, burning, or numbness
• Pain
• A feeling that something is inside the ball of the foot, or that there's a rise in the shoe or a sock is bunched up.
The progression of a Morton's neuroma often follows this pattern:
• The symptoms begin gradually. At first they occur only occasionally, when wearing narrow-toed shoes or performing certain aggravating activities.
• The symptoms may go away temporarily by massaging the foot or by avoiding aggravating shoes or activities.
• Over time the symptoms progressively worsen and may persist for several days or weeks.
• The symptoms become more intense as the neuroma enlarges and the temporary changes in the nerve become permanent.
What Causes a Neuroma?
Anything that causes compression or irritation of the nerve can lead to the development of a neuroma. One of the most common offenders is wearing shoes that have a tapered toe box, or high-heeled shoes that cause the toes to be forced into the toe box. People with certain foot deformities -- bunions, hammertoes, flatfeet, or more flexible feet -- are at higher risk for developing a neuroma. Other potential causes are activities that involve repetitive irritation to the ball of the foot, such as running or racquet sports. An injury or other type of trauma to the area may also lead to a neuroma.
Diagnosis
To arrive at a diagnosis, the foot and ankle surgeon will obtain a thorough history of your symptoms and examine your foot. During the physical examination, the doctor attempts to reproduce your symptoms by manipulating your foot. Other tests may be performed. The best time to see your foot and ankle surgeon is early in the development of symptoms. Early diagnosis of a Morton's neuroma greatly lessens the need for more invasive treatments and may avoid surgery.
Treatment
In developing a treatment plan, your foot and ankle surgeon will first determine how long you've had the neuroma and evaluate its stage of development. Treatment approaches vary according to the severity of the problem.
For mild to moderate cases of neuroma, treatment options include:
• Padding. Padding techniques provide support for the metatarsal arch, thereby lessening the pressure on the nerve and decreasing the compression when walking.
• Icing. Placing an icepack on the affected area helps reduce swelling.
• Orthotic devices. Custom orthotic devices provided by your foot and ankle surgeon provide the support needed to reduce pressure and compression on the nerve.
• Activity modifications. Activities that put repetitive pressure on the neuroma should be avoided until the condition improves.
• Changes in shoewear. It's important to wear shoes with a wide toe box and avoid narrow-toed shoes or shoes with high heels.
• Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation.
• Injection therapy. If there is no significant improvement after initial treatment, injection therapy may be tried.
When is Surgery Needed?
Surgery may be considered in patients who have not received adequate relief from other treatments. Generally, there are two surgical approaches to treating a neuroma the affected nerve is either removed or released. Your foot and ankle surgeon will determine which approach is best for your condition. The length of the recovery period will vary, depending on the procedure or procedures performed. Regardless of whether you've undergone surgical or nonsurgical treatment, your foot and ankle surgeon will recommend long-term measures to help keep your symptoms from returning. These include appropriate footwear and modification of activities that cause repetitive pressure on the foot.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
www.sarasotafootcarecenter.com

Special Report on Ankle Sprains

2012-01-17T11:24:00.000-08:00

What is an Ankle Sprain?

An ankle sprain is an injury to one or more ligaments in the ankle, usually on the outside of the ankle. Ligaments are bands of tissue -- like rubber bands -- that connect one bone to another and bind the joints together. In the ankle joint, ligaments provide stability by limiting side-to-side movement.
Some ankle sprains are much worse than others. The severity of an ankle sprain depends on whether the ligament is stretched, partially torn, or completely torn, as well as on the number of ligaments involved. Ankle sprains are not the same as strains, which affect muscles rather than ligaments.
What Causes a Sprained Ankle?
Sprained ankles often result from a fall, a sudden twist, or a blow that forces the ankle joint out of its normal position. Ankle sprains commonly occur while participating in sports, wearing inappropriate shoes, or walking or running on an uneven surface.
Sometimes ankle sprains occur because of weak ankles, a condition that some people are born with. Previous ankle or foot injuries can also weaken the ankle and lead to sprains.
What are the Symptoms?
The signs and symptoms of ankle sprains may include:
• Pain or soreness
• Swelling
• Bruising
• Difficulty walking
• Stiffness in the joint
These symptoms may vary in intensity, depending on the severity of the sprain. Sometimes pain and swelling are absent in people with previous ankle sprains -- instead, they may simply feel the ankle is wobbly and unsteady when they walk. Even if you don't have pain or swelling with a sprained ankle, treatment is crucial. Any ankle sprain -- whether it's your first or your fifth -- requires prompt medical attention.
If you think you've sprained your ankle, contact your foot and ankle surgeon for an appointment as soon as possible. In the meantime, immediately begin using the "R.I.C.E." method -- Rest, Ice, Compression, and Elevation -- to help reduce swelling, pain, and further injury.
Why is Prompt Medical Attention Needed?
There are four key reasons why an ankle sprain should be promptly evaluated and treated by a foot and ankle surgeon:
1. An untreated ankle sprain may lead to chronic ankle instability, a condition marked by persistent discomfort and a "giving way" of the ankle.
2. You may also develop weakness in the leg.
3. You may have suffered a more severe ankle injury along with the sprain. This might include a serious bone fracture that could lead to troubling complications if it goes untreated.
4. An ankle sprain may be accompanied by a foot injury that causes discomfort but has gone unnoticed thus far.
Rehabilitation of a sprained ankle needs to begin right away. If rehabilitation is delayed, the injury may be less likely to heal properly.
In evaluating your injury, the foot and ankle surgeon will take your history to learn more about the injury. He or she will examine the injured area, and may order x-rays, an MRI study, or a CT scan to help determine the severity of the injury.
Non-Surgical Treatment and Rehabilitation
When you have an ankle sprain, rehabilitation is crucial -- and it starts the moment your treatment begins. Your foot and ankle surgeon may recommend one or more of the following treatment options:
• Immobilization. Depending on the severity of your injury, you may receive a short-leg cast, a walking boot, or a brace to keep your ankle from moving. You may also need crutches.
• Early Physical Therapy. Your doctor will start you on a rehabilitation program as soon as possible to promote healing and increase your range of motion. This includes doing prescribed exercises.
• Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation. In some cases, prescription pain medications are needed to provide adequate relief.
• Icing. You may be advised to ice your injury several times a day until the pain and swelling resolves. Wrap ice cubes, or a bag of frozen peas or corn, in a thin towel. Do not put ice directly on your skin.
• Compression Wraps. To prevent further swelling, you may need to keep your ankle wrapped in an elastic bandage or stocking.
When is Surgery Needed?
In more severe cases, surgery may be required to adequately treat an ankle sprain. Surgery often involves repairing the damaged ligament or ligaments. The foot and ankle surgeon will select the surgical procedure best suited for your case based on the type and severity of your injury as well as your activity level.
After surgery, rehabilitation is extremely important. Completing your rehabilitation program is crucial to a successful outcome. Be sure to continue to see your foot and ankle surgeon during this period to ensure that your ankle heals properly and function is restored.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
www.sarasotafootcarecenter.com

Special Report on Ingrown Toenails

2012-01-17T11:21:00.000-08:00

Special Report on Ingrown Nails

If you have ever had an ingrown toenail, you know the feeling. All of a sudden you have this sharp pain at the side of your toe. If you are like me and have had a few ingrown nails, the pain in your toe immediately creates a sickness in your stomach. You think, “Oh no! Not again.” The pain is amazing. You wonder how it is possible for something so seemingly small to hurt so much.
What is an ingrown nail? When a toenail is ingrown, the nail is curved downward and grows into the skin, usually at the nail borders (the sides of the nail). This "digging in" of the nail irritates the skin, often creating pain, redness, swelling, and warmth in the toe. If an ingrown nail causes a break in the skin, bacteria may enter and cause an infection in the area, which is often marked by drainage and a foul odor. However, even if your toe isn't painful, red, swollen, or warm, a nail that curves downward into the skin can progress to an infection.
What Causes an Ingrown Toenail? Ingrown toenails can develop for various reasons. In many people, the tendency to have this common disorder is inherited. In other cases, an ingrown toenail is the result of trauma, such as stubbing your toe, having an object fall on your toe, or engaging in activities that involve repeated pressure on the toes, such as kicking or running. The most common cause of ingrown toenails is improper trimming. Cutting your nails too short encourages the skin next to the nail to fold over the nail. Another cause of ingrown toenails is wearing shoes that are tight or short. Certain nail conditions are often associated with ingrown toenails. For example, if you have had a fungal toenail infection or if you have lost a nail through trauma, you are at greater risk for developing an ingrown toenail.
What is the treatment for an ingrown nail? Home treatment is strongly discouraged if you suspect you have an infection, or if you have a medical condition that puts your feet at high risk -- for example, diabetes, nerve damage in the foot, or poor circulation.
If you don't have an infection or any of the above conditions, you can soak your foot in room-temperature water (add Epsom's salt if you wish), and gently massage the side of the nail fold to help reduce the inflammation. Avoid attempting "bathroom surgery." Repeated cutting of the nail can cause the condition to worsen over time. If your symptoms fail to improve, it's time to see a foot and ankle surgeon.
Physician care:
The foot and ankle surgeon will examine your toe and select the treatment best suited for you. Treatment may include:
• Oral antibiotics. If an infection is present, an oral antibiotic may be prescribed.
• Surgery. A simple procedure, performed in the office, is needed to ease the pain and remove the offending nail. Surgery will involve numbing the toe and removing a corner of the nail, a larger portion of the nail, or the entire nail.
• Permanent removal. Various techniques may be used to destroy or remove the nail root. This treatment prevents the recurrence of an ingrown toenail. Your foot and ankle surgeon will determine the most appropriate procedure for you. Following nail surgery, a light bandage will be applied. Most people experience very little pain after surgery and may resume normal activity the next day. If your foot and ankle surgeon has prescribed an oral antibiotic, be sure to take all the medication, even if your symptoms have improved.
How can I prevent ingrown toenails? Many cases of ingrown toenails may be prevented by following these two important tips:
• Trim your nails properly. Cut your toenails in a fairly straight line, and don't cut them too short. You should be able to get your fingernail under the sides and end of the nail.
• Avoid poorly-fitting shoes. Don't wear shoes that are short or tight in the toe box. Also avoid shoes that are loose, because they too cause pressure on the toes, especially when you run or walk briskly.
But what about cotton, or the “v” cut in my nail? Unfortunately there are many myths concerning ingrown nails and their treatment. These myths cause people to delay care or to believe that must simply live with ingrown toenails.
Myth 1: Cutting a notch (a "V") in the nail will reduce the tendency for the nail to curve downward.
Truth: Cutting a "V" does not affect the growth of the toenail. New nail growth will continue to curve downward.
Myth 2: Repeated trimming of the nail borders is a good way to treat ingrown toenails.
Truth: Repeated nail trimming fails to correct future nail growth and can make the condition worse.
Myth 3: Cotton placed under the nail will relieve the pain.
Truth: Cotton placed under the nail can be harmful. It can easily harbor bacteria and encourage infection.
Myth 4: You can buy effective ingrown toenail treatments at the drug store.
Truth: Over-the-counter topical medications may mask the pain, but they fail to address the underlying problem.
Myth 5: There is no long term cure for ingrown toenails.
Truth: Permanent removal is possible. There is no need to suffer with ingrown nails!

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
www.sarasotafootcarecenter.com

More Than Just Foot Care

2011-09-20T11:08:00.000-07:00

We at Sarasota Foot Care Center believe that you not only treat the foot and ankle, but the person attached to that foot and ankle. As such, we just want to remind our patients that we are involved in ALL ASPECTS of your lower extremity health. We not only treat skin, nail and bone deformities of the foot and leg, but we also treat sprains, fractures, diagnose blood flow and neurologic problems and treat wounds.

We have the latest technology to diagnose and treat fractures using digital x-rays in our office. As you may have noticed, we use computers in the treatment room as part of an electronic medical record. Not only is this more accurate but it also cuts down on paper and helps save the environment. We also have one of the few cutting –edge lasers in the area to treat fungal nail infections.

Finally, we are a center of excellence for diabetic foot care. We follow all of the American Diabetes Association (ADA) guidelines with regard to blood flow testing and nerve testing and we perform the tests in our office. We offer electrical stimulation therapy for the treatment of painful, tingling neuropathy in your feet. We even offer diabetic shoes for those who qualify.

At Sarasota Foot Care Center we are more than just foot care, we are total patient care.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com

Special Report on Orthotics

2011-08-29T07:08:00.000-07:00

First of all, what are orthotics? Orthotics are custom made devices that fit inside your shoes and improve the function of your feet and ankles. You can think of them as “glasses for your feet.” Just like a pair of glasses causes your eyes to function in the proper way, a pair of orthotics improves the function of your feet and ankles. It also decreases pressure on the bones and skin of the foot, decreases pain and aligns the joints of the foot, ankle and knee.

What aren’t orthotics? Orthotics are not soft, gel or foam things that you can bend with your fingers. For an orthotic to work it must put your foot into a position that your foot does not want to go. During walking, all your weight is on one foot at a time. Imagine all of your weight on a soft, gel or foam device. It will flatten to nothing and will not improve the function of your foot.

Are orthotics comfortable? Absolutely, when they are made properly you don’t even feel them in your shoes. The only way that a pair of orthotics will be strong enough to work and yet comfortable enough that you will actually wear them, is to have them custom molded exactly to your foot.

But what about the ones you can get at the drug store from “the machine” or from the “foot store?” Collectively, the doctors of Sarasota Foot Care Center have been practicing medicine for well over 65 years. Not only do we know how to get you the true orthotic you need, but we will be there to help you down the road if anything happens and adjustments are needed. Try that with the “machine” or the “foot store.”

But aren’t they expensive? Expensive is when you pay good money for something and get no results. We don’t care if the so-called orthotics you can get at the shoe store only cost $60 dollars, they won’t help you. So is $60 dollars for a worthless pad a good deal? I don’t think so.

A pair of custom orthotics will last for about 3-5 years. It will improve your foot function and decrease your pain. Is that worth two installments of $225? How much does your heel hurt? How much would you pay to get out of the bed in the morning without that stabbing, shooting pain? How much would you pay to be able to exercise and finally lose those pounds you need to?

In these very sensitive economic times we completely understand priorities. If the decision is food or orthotics…that is a very simple decision. Another question you have to ask yourself is if you can afford not to get orthotics? Can you afford to miss more work because of your foot pain? Can you afford to take 6 weeks off because of a possibly avoidable surgery? There is not one golfer we know that would not pay that cost to shave a few strokes off of their game. How much easier would tennis be without the pain in the ball of your foot?

What foot conditions do orthotics treat? Orthotics treat a large group of conditions that all stem from the movement of the muscles and bones of the foot. These conditions include, but are not limited to: heel pain, heel spurs, flat feet, “fallen arches,” bunions, neuromas (pinched nerve in the foot), painful corns and calluses under the ball of the foot, sore feet and ankles, tendonitis and joint pain.

What will happen if I need orthotics but I don’t get them, can I do permanent damage to myself? Yes you can. Flat feet are genetic and are usually noticed early in life. If untreated, the excess pressure and abnormal wear and tear on the joints can lead to severe arthritic conditions and loss of function. Heel pain is ultimately a problem with alignment and no amount of stretching or cortisone shots will cure the problem with out addressing the underlying alignment issues. In fact, all the conditions that are treated with orthotics have a major alignment component to them. Leaving this alignment uncorrected only leads to further pain and loss of function. It is critical to correct the root cause of these conditions and the root cause is the deranged alignment. Orthotics are the only thing that can correct this alignment problem.

Will I have to get bigger shoes to fit the orthotics? No, you should not need a larger size to fit your orthotics. Most athletic shoes have a removable foot bed that will create the room needed to fit the orthotics. The same goes for most lace-up loafers or boots. In fact, there are some sandals that have a removable foot bed and work with orthotics as well. There are, of course some shoes that will not work with orthotics. High heels and flip-flops come to mind immediately. Have no fear. If you wear the orthotics when you are most active, occasional flip-flops and high heels are acceptable.

If you have been experiencing pain or soreness in your foot, what are you waiting for? Biomechanical problems, which is to say bone, muscle and joint problems, do not just heal themselves. You would never expect your vision to miraculously improve and you should not ask for miracles with your feet either. If your feet have been hurting you, or you have been watching someone you care about suffer with foot pain, stop waiting and get the pair of orthotics you need, today.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
www.sarasotafootcarecenter.com

Impressive NASCAR Victory...with a broken Ankle!

2011-08-16T10:58:00.000-07:00

Many people have debated wether or not to call NASCAR a true "sport" and wether or not to call NASCAR drivers true "athletes." Last week at Pocono Raceway a young driver named, Brad Keselowski proved that "athlete" or not, he had great courage and a will to win. Having broken his ankle in a practice run earlier in the week, not only did this gritty young man compete...he won! A broken ankle is a serious injury that often requires surgical repair with plates and screws, not unlike the repairs of the cars these guys drive, just cleaner. Typically a broken ankle will keep someone from walking for several weeks and that goes for driving too. Mr. Keselowski had other ideas. With a very swollen, bruised and I am quite sure very painful ankle, he took the checkered flag and proved that NASCAR drivers are tough if nothing else. I applaud his courage, but as a foot doctor I have to recommend that if you ever have the bad fortune of a broken ankle you have it treated immediatly, not after you win the next race!

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
www.sarasotafootcarecenter.com

British man removes wart...with a shotgun?!?

2011-06-20T12:31:00.000-07:00

This guy wins the prize for taking things into his own hands. You may have heard the expression, "if you want to make an omelette you have to break a few eggs." This gentleman in England had a wart on his finger for several years. He claims to have tried several options to cure these pesky lesions, all with no success. It is at this point that he decided to stop playing games. He loaded a shotgun and blasted the wart off his finger...well to be more accurate he blasted his finger off with the wart still attached to it! There was no finger left to even attempt to reattach it. If the story is not strange enough yet, it gets weirder. In England it is very difficult to get a gun. This man did not have the proper paperwork and as such he faced up to 15 years in jail just for possessing the gun. He claims he found the gun in the hedges near his home. I guess the judge felt sorry for the poor guy because he got off with a fine, some community service and time served...oh yeah and he lost a finger! Got to love the justice system. For his part the man said he is happy to see the finger gone. The wart was so annoying that he is happier this way.
I am posting this to (hopefully) make you laugh and also to tell you that you don't have to use a shotgun to remove your warts. There are plenty of options to help remove these painful lesions without shooting off parts of your anatomy. For more information, please refer to my blog, "Do You Really Get Warts From Frogs," on December 19, 2008. Please, please, please put the shotgun down!

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
www.sarasotafootcarecenter.com

Sketchers Has Really Stepped In It This Time

2011-05-17T08:43:00.000-07:00

We have all seen the commercials. The sexy women with the great rear ends bounce around as the voice over guy tells you that you too can have a body like this if you would only buy Sketchers Shape-Up shoes. No dieting or gym required...just plunk down your money and wear the shoes in your normal day and presto! Well, not so fast. As I wrote in an earlier blog this nonsense is totally unfounded. Any independent study of the Shape-Up shoes, or rocking type shoes by other copycat companies, proves that these shoes do absolutely nothing to help you burn more calories or have your leg muscles work more. In fact, some recent studies show that there is increased pressure on the ankle and knee as well as the hamstrings and these shoes can actually lead to injury. If that were not bad enough, now Sketchers is in the news for marketing these shoes to 7 year old girls. This disgraceful attempt to make money by playing on the insecurities of pre-teen girls has many parents fed up.
A class action lawsuit is pending against Sketchers for false advertising and misleading the public with false health claims. I for one am happy to see this. Many of my patients ask me about these shoes and when I give my opinion they are disappointed. They are looking for the magic bullet. Like your mother always told you...if it seems to good to be true it is. If you are dealing with foot pain you should see a podiatrist who is trained in the treatment of feet and ankles. If you are looking for a good shoe to exercise in, you should wear a well fit shoe that passes a few simple tests. See my earlier blog on how to pick the right shoes for you. If you are looking to lose weight, exercise and diet are the only way to effectively do that in the long term. Don't believe Joe Montana, Wayne Gretzky or Kim Kardashian. They are paid to lie to you!

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com

X-rays Negative on NBA MVP Derrick Rose

2011-05-03T11:23:00.000-07:00

Derrick Rose, the Chicago Bulls superstar and likely leage MVP, had some good news the other day. The x-rays on his injured left ankle came back negative. That is to say that there is no fracture of the bones. The ligaments, soft tissues that hold bones together, can not be seen on an x-ray. The most frequent ankle injury is called an inversion ankle sprain. This is when the foot rolls to the pinky toe side of the foot. Rose suffered this injury coming down on another players foot in a game against the Pacers. Rose continued to play and the Bulls put away the Pacers but now that the Atlanta Hawks have won game one, all of a sudden Rose's ankle is very important. I do respect Derrick Rose's determination, but if the ligaments are truly torn he will be very limited in his lateral movement. This could be very bad for the Bulls. Lucky for Derrick Rose that he has around the clock access to physical therapy on his ankle. For anyone who is not an elite, multi-million dollar athlete, the treatment for ankle sprains is P-R-I-C-E. Protection, Rest, Ice, Compression and Elevation. Motrin or Advil will also help with the pain. If the pain lasts longer than a week or if you are unable to bear any weight on the ankle, you should see a podiatrist immedatly to have an x-ray. Often bracing combined with physical therapy will get you back out on the court in a few weeks. Lucky for you, the entire city of Chicago is not counting on you to bring home a championship!

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
www.sarasotafootcarecenter.com

A Day Without Shoes

2011-04-05T06:03:00.000-07:00

Why are all those people barefoot? What is going on? Today, April 5th 2011, is the annual day without shoes. This event was started on a college campus about 5 years ago and has really stated to generate buzz over the past couple of years. In fact, last year over 250,000 people participated. TOMS shoes is the primary sponsor of the day. TOMS is a shoe retailer/charitable company, that donates one pair of shoes to needy children for every pair that is sold. This "one for one" philosophy is the core of the TOMS business model.
What is all the fuss about? Well, we forget that having shoes is actually a luxury for many children in countries around the world. The lack of shoes puts these children at risk for disease, injury and impairment. There are many schools that actually require children to have shoes to attend and thus lack of shoes can hold back a child from educational opportunity.
We at the Sarasota Foot Care Center have been gathering gently used shoes to be donated to the Salvation Army right here in Sarasota for over a year. The "spare a pair" shoe campaign has delivered hundreds and hundreds of pairs of shoes to needy people right here in our own community. However you choose to get involved, just get involved. Donate your time, money or shoes to help those less fortunate.
If not you, who? If not now, when?

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
www.sarasotafootcarecenter.com

The Truths and Lies About Nail Fungus

2010-10-01T10:50:00.000-07:00

Do you remember the Lamisil commercials with the yellow little creature that lived under the toenails? The ad campaign was very popular and the little yellow creature was called Digger the dermatophyte. A dermatophyte is a fungus that lives on skin or nails and if you have thick, yellow, crumbly toenails than you have dermatophytes living on your nails right now.
There are millions of Americans who suffer with nail fungus. It is embarrassing and sometimes painful but there are solutions for this disease. My job in this article is to sift through all the information that is out there and separate the facts from the fiction.
First off, who gets nail fungus? Anyone with nails. Men and women are equally at risk. There is no bias based on race. Why does it seem like older people have more nail fungus? The reason is because the longer you live the longer your nails are exposed to nail fungus. You don't have to be a senior citizen to have nail fungus. I treat many people in their 20's and 30's with the condition.
What causes nail fungus? The truth is that nail fungus is genetic. Our genes determine so many things about us, height, hair color and susceptibility to certain infections. The people whose genes just so happen to have difficulty killing this fungus are the ones that ultimately wind up with the infection. Make no mistake, nail fungus is an infection. It is caused by the same fungus that causes athlete's foot.
OK, so what doesn't cause nail fungus? Pedicures, high heeled shoes and nail polish have all been implicated in the cause of nail fungus. This is simply not true. The vast majority of men have never had a pedicure, worn high heels or used nail polish and yet men are just as likely to have nail fungus as women.
What doesn't treat nail fungus? Vick's vapor rub, bleach, Epsom salt, vinegar and just about any other household cleaning product have been discussed as treatments to nail fungus. This is absolute fiction. I don't care what Dr. Oz or Oprah says. There has never been a study to prove than any of these cleaners do anything to nail fungus. I know, but you heard that a guy at work had a friend that had a sister-in-law that used Vick's on her nails and it worked like a charm. Trust me; if any of these products really worked they would be marketed as such. I am a foot doctor that treats this stuff every day and even when we use FDA approved topical medications on nail fungus the rate of improvement is less than 25%.
This leads me to the final question, what does treat nail fungus? As I said, there is an FDA approved topical medication and it is called Ciclopirox. It must be applied every day for a year and it has about a 15-25% rate of improvement. You could take Lamisil pills, now generic and called Terbinifine, once a day for 90 days. The drug is filtered through your liver, just like most drugs, so you must have a simple screening blood test prior to starting the medication to make sure your liver is healthy. This therapy has about a 75% rate of improvement. The final therapy is light therapy or Laser therapy. This treatment consists of amplified light applied to the nail to kill the fungus. The treatment is painless, it takes 15 minutes for 3 sessions and it does not interact with any medications at all. It is the safest therapy available. This light therapy is the newest on the market and unfortunately is not covered by insurances. The cost is between $600 and $1300 depending on the number of nails affected. The rate of improvement is 85% which makes it the most effective treatment available.
Whether you need topical treatments, pills or the new laser is up to you and your foot doctor to decide, but at least now you know the truths and the lies about nail fungus.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com

Do You Have Thick, Yellow, Ugly Toenails?

2010-09-24T06:32:00.000-07:00

If you are one of the 35 million Americans that have thick, yellow, ugly toenails than this information is for you. A new and exciting treatment option is finally available. No more will you have to hide your toenails. No more will you have to take a pill that may interact with other medicines and must be filtered through your liver.
Now the Noveon Laser has entered the market. A recent study published in a major podiatric medical journal reports 85% improvement in appearance of nails 6 months after treatment. The laser is safe, painless and takes as little as 3 separate 15 minute sessions, spread out over 2 months. Just like any technological breakthrough the Noveon Laser is not covered by medical insurance. The cost of treatment depends on the number of toenails involved and the severity of the infection. To give you an estimate of the cost, it ranges from $600-$1400. Remember that Lamisil pills used to cost over $1000 dollars and topical treatments cost several hundred dollars over the course of the year, not to mention the time and aggravation.
For years people have been clamoring for a new and effective treatment to this embarrassing condition and now it has arrived. Be one of the first to have your nail fungus safely, effectively and painlessly treated with the most modern of technologies.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com

Simply No Evidence for Toning Shoes

2010-09-10T06:33:00.000-07:00

We have all seen the commercials. Joe Montana sells the Shape-Up shoe for Sketchers and various models bounce around with tight shorts showing off the great butts they supposedly attained simply wearing a toning shoe. Sorry, but you mother was correct...if it seems to good to be true, it probably is. I hate to be the one to burst your bubble but all the slick marketing aside, a recent study by the American Council on Exercise found "simply no evidence" that the shoes aid in more intense exercise, burn more calories or improve strength and tone. I will repeat that...there is no evidence that these expensive shoes do ANYTHING that they advertise. Nothing. As a foot doctor I am asked about these shoes all the time. My response was always the same, I don't think that the shoes will hurt you, but they are definitely not any kind of miracle. If you want toned legs and a toned butt there are no short cuts. Decrease you caloric consumption, eat a a healthy diet and perform a balanced exercise program in standard athletic shoes. I know that is not exciting. I know that I can't sell that with commercials of retired athletes...but it is true. Hey these shoes will make you lose some weight...in your wallet. Save your money and go exercise.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com

The Ghost in the Machine

2010-07-06T10:21:00.000-07:00

If you have been to the drug store or grocery store lately you may have noticed the Dr. Scholl's machine. It looks impressive enough, with colorful images of your feet that show the different pressures. After standing on the machine for a few seconds it spits out a number and that is the pair of foot supports that you are supposed to use. Simple right? Wrong.
Custom foot supports, or orthotics as they are called by foot doctors, are a complicated science. The science of how living things move is called biomechanics. This is the science that one must you to properly diagnose and treat conditions with a pair of orthotics. The machine has none of this training. The foot is a very dynamic structure with 28 bones, 33 joints and over a hundred ligaments in each foot. Placing the foot in the proper position is crucial in obtaining a good representation of this moving target.
As an example, we have all heard of someone having 20/20 vision. What that means is that at a standard of 20 feet a person can see a size of type that has been designated as the standard font. This system breaks down if you measure people at 10 feet or with a different font size. When molding someone for an orthotic in my office I have similar standards that I have to abide by. The foot, ankle and knee must be in the standardized position. If not taken in this very specific way the mold is useless. This is exactly what happens with these machines. There is no uniformity. There is no standardizing.
As someone who has prescribed hundreds of orthotics in my career I can tell you that there is an art as well as a science involved. You have to know the activity level of the patient and the types of shoes they most often wear. There are some sport specific adjustments that can be taken into account and let us not forget the follow up. When you get a pair of orthotics from me or my colleagues you are sure to have the devices evaluated and any adjustments made in order to get the results you want. Every year thousands of people buy a 1/4 inch drill bit. None of these people want a 1/4 inch drill bit...they want a hole that is 1/4 inch around. The same can said for orthotics. No one really wants a piece of custom molded plastic in their shoe...they want pain free walking, running, golfing etc.
People often ask why orthotics are so expensive. The answer is because they are time consuming if you are going to do them correctly. You can get a piece of padded plastic out of a machine in a grocery store all day if you want to, just don't call that an orthotic. The ghost in the machine is not going to follow up with you. The ghost does not care if the device works. The ghost is not going to adjust the device and improve your comfort and quality of life.
You do get what you pay for in life and this is just another example of cutting corners and you will suffer for it. Remember that when you do end up with a inferior device you only have yourself to blame...the ghost in the machine doesn't care.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
www.sarasotafootcarecenter.com

Latest Treatments for Fungal Toenails

2010-06-16T08:25:00.000-07:00

There has been a lot of interest and confusion when it comes to the newest treatment for Onychomycosis (fungal toenails). There are a few companies that have been marketing their product to podiatrists and the public. The systems that are now available differ in their delivery systems as well as the number of treatments needed. The PinPointe system referenced in the linked article is operator dependent which means the doctor must try to reach all areas of involvement using a hand held wand.

The Nomir Laser uses pods over every toe which bathes the entire area leaving operator judgment out of the treatment equation. Also, the PinPointe treatment is a one-time higher energy approach while the Nomir uses a gentler, more patient friendly, low energy 3 treatment approach. The doctors of SFCC will be starting our program with the Nomir Laser very shortly. Please call the office for an appointment to discuss your case.

http://www.nytimes.com/2009/03/20/business/20fungus.html

Dedicated to your foot health,
Dr. Jeffrey M. Spiegel, DPM

New York Mets 2nd Baseman has a Foot Injury

2010-06-07T10:22:00.000-07:00

The New York Mets second baseman, Louis Castillo, could end up on the disabled list due to a foot injury. The injury is being reported as a bone bruise of the left foot. What is a bone bruise? Most people think a bone is either broken or not. In order to explain that I want you to think of a dimmer switch on a light. You see, a bone can be either broken or not, just like a light can either be on or off. That said, there are also the dimmer options. Using an MRI (a special medical device that takes images of the bones and soft tissues and feeds the results into a computer) a radiologist can add more options to the mix. Thinking of a spectrum, where one end is normal bone and the other is a broken bone, now we can add bone bruise (also called a stress reaction) and stress fracture.
Despite his desire to play, the treatment for a bone bruise is rest, stiffer shoes and time. If he continues to play on this foot he can end up with a stress fracture (the next phase on the dimmer switch) or ultimately a fracture of his bone. If he does fracture the bone he is looking at 6 weeks of healing time.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
www.sarasotafootcarecenter.com

Do These Genes Make Me Look Fat?

2010-04-06T07:40:00.000-07:00

For a long time now, scientists have know that there are certain genetic variants that increase the likelyhood of obesity. One of those gene clusters, the FTO gene, is affectionately called the "fatso" gene. This genetic variant is very common. In fact, 1 in 6 people have the FTO gene variant and these people weigh an average of 7 pounds more than people with the regular variant.
Many experiments with animals have proven that specifically inhibiting these genes will cause rapid weight loss, yet no magic pill has come out yet that can help the millions of overweight and obese Americans.
In a recent study, just published in the April addition of the Archives of Pediatric and Adolescent Medicine scientists discovered some very encouraging news. We do not have to be slaves to our genes. In the study of over 700 teens it was found that those teens with a high genetic tendency for obesity could compensate with one hour of moderate exercise a day. Those teens who did one hour of exercise a day were found to have statistically similar waist measurments, body mass index scores and body fat levels as their peers with regular genes. Playing sports, running, jumping rope and cycling were all forms of exercise that qualify.
So if you or your children are one of the over 200 million overweight Americans, the time is now to start getting active.
In the process of getting active make sure you have the proper shoes for your exercise program. If you do have foot or leg pain that is stopping you from reaching your exercise goals, see a foot doctor and learn what you need to do to exercise safely and efficently. Your genes do not have to determine your destiny. You have control over your life.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com

Major Soccer Star Tears Achilles Tendon

2010-03-15T08:26:00.000-07:00

British soccer star and frequent tabloid subject, David Beckham, tore his Achilles tendon in a game in Italy this weekend. The footballer will miss all of the World Cup and probably most of the MLS season due to the injury. Becks, as the British press is so fond of calling him, injured the foot in a non-contact aspect of the game. He was just walking around the field when he fell and clutched his heel.
The Achilles tendon is so named after the Greek mythological character who was only vulnerable at the back of his heel. According to the legend, Achilles was dipped in a river by his mother and protected from all harm. Of course his mother had to hold onto some part of young Achilles and allegedly she held him by his heel. Not to spoil the story for you but Achilles is killed by an arrow that hits him right in his heel. What are the chances?
Myth aside, the Achilles tendon has been the downfall of many a great athletic hero. Dan Marino, one of the greatest quarterbacks in football history, had his career ended in a similar non-contact injury. Misty May-Trainor, an Olympic gold medalist in beach volley ball, suffered an Achilles rupture during her time on a television dancing show. What is going on here? These are elite athletes and they are sustaining this major injury while doing basically minimal activity. How is this possible?
The most likely cause is chronic Achilles tendinitis. The Achilles tendon is the biggest, thickest tendon of the body and it allows the calf muscles to point the foot down. This is critical for both running and jumping. Elite athletes and weekend warriors can get a sharp, painful feeling in the back of the heel, especially when getting out of bed in the morning or first getting out of a chair. This pain represents inflammation and tightness at the attachment site of the tendon and the heel bone. If left untreated this tendinitis can weaken the tendon and lead to a rupture.
If you don't want to be added to the list of people with a ruptured Achilles tendon always stretch before you begin strenuous physical activity and see a foot doctor sooner rather than later if you have sharp pain in the back of your heel.

Committed to your health,
Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com

Why Do Football Players Heal Faster Than Us?

2010-02-08T07:24:00.000-08:00

In case you missed it, Dwight Freeney, the All-Pro defensive end for the Indianapolis Colts had a very good game during the Superbowl, despite a torn ligament in his right ankle. But wait, he only injured his ankle 2 weeks ago...how is he playing football when my doctor told me that my ankle sprain would sideline me for 3-6 weeks? In short, why do football players heal faster than regular people like you and me? The answer is that they don't heal faster than we do. Ligaments take 3-6 weeks to heal in anyone. Elite athletes just so happen to be in incredible physical shape as well as an ability to tolerate pain that is beyond the average person. Dwight Freeney is a professional football player. He has played countless games in high school, college and the pro's. He has played through pain.
On Sunday you can bet that his ankle was heavily braced with tape and strappings to limit the motion of his injured ankle. He was also most likely injected with a drug called Marcaine which is very similar to the Novacaine used in a dental office. This type of medicine causes a few hours of painless numbness, but it does not repair or heal tendons or ligaments.
Dwight Freeney had a great game. He even sacked New Orleans quarterback Drew Brees in the second quarter. He is not a superhuman. He is a professional athlete with the best medical care at his disposal and he may have made it through the game, but his ankle is not healed. He does not heal faster than you or me. He just knows that Superbowls are once in a lifetime and he can heal in the offseason.
If you sprain your ankle, don't expect to get back to full activity for 3-6 weeks. You will need to ice, elevate and rest your ankle as well as taking anti-inflammatory pills and wearing a brace. But don't worry, if by some chance you need to play in the Superbowl in 2 weeks...we could get you ready.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com

Coffee and Tea Can Reduce Your Risk Of Type 2 Diabetes

2009-12-15T05:45:00.000-08:00

Good news for all you Starbucks fanatics out there. A recent analysis of several studies has shown something of a protective effect of coffee and tea when concerning Type 2 Diabetes. The researches are not exactly sure what is garnishing this protective effect. It is not specifically caffine because decaf coffee also showed reduced risk for diabetes.
One theory is that some of the chemical compounds in coffee and tea affect sugar metabolism. Green tea, black tea and oolong tea have shown the ability to boost the effect of insulin. Now the headlines are going to read, "each cup of coffee a day gives you a 7% less chance of getting Type 2 Diabetes." Not so fast. This particular kind of analysis can skew statistics a little because it adds many studies together to make predictions. Some of those studies have very small sample sizes and others are not exactly the most controlled studies. Also, this is talking about coffee and tea, not a 20 oz. carmel-mocha-choca-latte. Those dessert-type drinks have hundreds of calories and tons of sugar.
Bottom line, just like one or two glasses of red wine can have a protective effect against heart disease, coffee and tea can have a similar effect on Type 2 Diabetes. In both of these cases we are talking about supplemental effects. A healthy lifestyle based on diet and exercise can not be overstated. There are no shortcuts on the path to health, but a glass of wine and cup of tea sure can make the journey a little more enjoyable.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com

What is a Stress Reaction

2009-11-30T13:16:00.000-08:00

Previously reported on this blog, I am both a foot doctor in Sarasota, Florida and a New York Giants football fan. The latest out of New York is that Eli Manning has more to worry about than his long suffering plantar fasciitis. Now it has been reported that Eli has a "stress reaction" in a bone called the cuboid bone of his foot.
Well, what is a "stress reaction?" In order to explain that I want you to think of a dimmer switch on a light. You see, a bone can be either broken or not, just like a light can either be on or off. That said, there are also the dimmer options. Using an MRI (a special medical device that takes images of the bones and soft tissues and feeds the results into a computer) a radiologist can add more options to the mix. Thinking of a spectrum, where one end is normal bone and the other is a broken bone, now we can add stress reaction and stress fracture.
Eli has a stress reaction. The treatment for this is rest, stiffer shoes and time. If he continues to play on this foot he can end up with a stress fracture (the next phase on the dimmer switch) or ultimately a fracture of his cuboid bone. If he does fracture the bone he is looking at 6 weeks of healing time, which basically means the season is over for him.
With Eli hurt and the Giants on a 5-game-out-of-6 losing streak the stress is affecting all Giants fans.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
Sarasotafootcarecenter.com

Should Kids Wear High Heels?

2009-11-20T12:44:00.000-08:00

Recently there has been a lot of press about Suri Cruise and her little silver high heels. There is nothing quite like a celebrity (or the child of one) to bring these types of things to the forefront of the public consiousness. So, should kids wear high heels? My answer is no, they SHOULD not wear high heels. That said, they certainly CAN wear high heels. The question is similar to should kids eat cheeseburgers and fries. No they shoud not, but they can, in moderation with adult supervision without any major disasters.
Many of my female patients in Sarasota, Florida are afraid that I am going to tell them that they can never wear high heels again. The truth is that high heels do increase pressue on the balls of the feet(what we call the metatarsal heads), can cause shortening of the Achilles tendon and increase the chances for falling or spraining an ankle. That said, many of the sports that I enjoy can possibly lead to all kinds of injuries. Tennis, basketball, skateboarding, roller blading, marathon running etc, can all possibly cause injury to the foot and ankle. All of these activities have the same warnings as high heels. Where is the outcry to stop kids from doing any of these?
Do I think it is a little silly for a kid to wear high heels, I guess. What I find even more silly is that it has become such a big news item in the complex world we live in.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com

Diabetes Awareness Month Is Upon Us

2009-11-03T08:37:00.000-08:00

November is National Diabetes Awareness Month. Kind of ironic when you think that you have most of the major holidays in this time of year. The average American gains several pounds and for a diabetic and their family, this can be a very challenging time of year. Staying consistent with your eating habits, limiting the simple sugars and indulgence in alcohol can help to protect the almost 40 million diabetic feet in this country.

For many years we have seen our own patient population in Sarasota, Florida suffer ill affects of this dangerous time of year. Ulcerations, gout attacks, leg swelling all increase as the New Year begins. I know there is a lot of fear and denial about infections, ulcerations and amputations. In order to avoid these horrible complications of diabetes we need to do some simple things and apply some basic discipline.

Step 1: check your sugar frequently and keep your Hemoglobin A1C ( a lab value that your primary care doctor or endocrinologist tests to get an average of your blood sugar over a few month period) in the proper range.
Step 2: see a foot doctor at least yearly and have a neurological test (a test of feeling and sensation in your feet) and vascular test (a test of blood flow to the feet and legs) as recommended by the American Diabetes Association.
Step 3: wear comfortable, well fit shoes with protective inserts when needed. The Medicare Diabetic Shoe Bill allows for one pair of diabetic shoes with 3 pairs of inserts, annually, for those patients who are diabetic with complications and on medicare.
Step 4: check your feet every day for redness, blisters, wounds etc. If you find any of these things on your feet you need to contact your podiatrist right away and take the situation very seriously. Delaying treatment is major obstacle to healing.

This year's theme for Diabetes Awareness month is "it's a family affair." I could not agree more. I would like to extend that definition to your medical "family" as well. Diabetic patients are very complex with many issues that blur the lines of medical specialty. Often a team approach is needed to treat these complicated situations. If we all do our part we can control the disease and take care of all of our loved ones. After all, it is a family affair.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com/

The Real Risks of Marathon Running

2009-10-19T10:24:00.000-07:00

Unfortunately, three people died recently in the Detroit Marathon. The news media has made a very big deal of this. Are marathons "death races?" It is very risky to run a marathon? Let's look at the facts and stay away from the sensational news headlines.
The deaths are certainly very sad, but they must be taken in context. While this is tragic it is not a reason to avoid marathons. Several studies have been done on the risks of marathon running and the evidence is that running a marathon has a very low risk of death. In fact, the British Medical Journal, (BMJ) published an article in 2007 that looked at 750 marathon days. It accounted for over 3 million runners and over 14 million hours of running. In that very large sample there were 26 deaths. That is equal to an overall risk of 0.8 deaths per 100,000 runners, or 2 deaths per million hours of vigorous exercise. The authors of the study went one step further. They actually looked at the motor vehicle deaths that were avoided due to the roads being closed on race day. What they found was that 46 deaths, statistically speaking, were avoided due to the closed roads.
Amazingly, we drive everyday and think nothing of it. Many of us talk on the phone, drink coffee, play with the radio and check email all while driving. This is much more deadly than any marathon...ever. The media does not really report car accidents the same way as they do deaths in a marathon. Car accidents are so common that fail to register as "news."
Now for the positive side, let's look at all the good that comes from running marathons and training for them. The number one cause of death in this country is heart disease followed by cancer and stroke. All of these top 3 killers can be avoided, to some extent, by regular aerobic exercise and maintenance of a healthy weight. Though it is impossible to say how many lives a marathon saves, it is easy to see that it contributes to the overall health of thousands. To say nothing of the joy, friendship, sense of accomplishment and good old fashioned fun these races add to your life.
If you have never run a marathon and you want to, educate yourself. Learn how to train and how to keep yourself properly hydrated. Make sure you ask your doctor if you are healthy enough to take on that kind of challenge. Don't let fear get in your way and don't believe everything you read in the headlines.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com

One Giant Painful Foot

2009-10-09T06:38:00.000-07:00

My worlds collided last week as a New York Giants football fan and as a podiatrist living in Sarasota, Florida. I was watching the game when quarterback, Eli Manning pulled up lame after planting his right heel on a play action pass. My first thought was, "I really hope that was not his Achilles tendon." Luckily for me, and Eli and Giants nation, it was not the Achilles tendon but the plantar fascia that was injured. The plantar fascia is a tight band of connective tissue, basically a blending of many tendons, that goes along the bottom of the foot. Many people, as many as 1 in 4 Americans, will suffer from sharp, shooting pains in the bottom of the heel. Often this pain is worse when you get out of bed in the morning or when you stand up after sitting for a period of time.
The most common cause for this is called plantar fasciitis or inflammation of the plantar fascia. In my office in Sarasota I treat this condition every day. None of my patients are professional quarterbacks who have to plant their feet in order to throw footballs, but it is not a fun condition for a lawyer, waitress or hairdresser either. Typically this condition is treated with anti-inflammatory drugs like Advil, rest, ice, stretching and sometimes a cortisone injection. Taping of the foot or a small foot brace is also used to limit the pain. Long term treatment consists of stretching exercises and use of orthotics, a molded shoe insert that controls foot motion.
Not only do I treat this condition every day, I also suffered from it in my early twenties. I am pain free now due to orthotics and stretching.
I expect to see Eli out on the field on Sunday. First of all because it is amazing what you can do with cortisone, second because the guy just does not quit. Eli has made 82 consecutive starts including the one following a serious shoulder injury. He will start but hopefully the Raiders will allow the Giants to build up a big lead and allow Eli to take a break. I am sure his foot will feel much better if he does.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com

Dancing With the Stars is Hard On Your Feet

2009-09-16T08:30:00.000-07:00

The ABC network's very popular reality show, "Dancing with the Stars" has to deal with yet another foot related injury. Headlines were made when Olympic gold medalist and contestant on the show, Misty May-Treanor tore her Achilles Tendon. In fact, at the time I was interviewed by the local Sarasota news station to discuss the injury. Now, Tom Delay, the former Republican House Majority Leader has a "pre-stress fracture." In truth there is no such thing as a pre-stress fracture. The proper term is a stress reaction. I will explain what I mean. When x-rays were the only available test to evaluate bones you either saw a fracture or no fracture. Now with MRI scans, a special type of test using a magnet and a computer, you can see much greater detail. A stress fracture is when a bone is repeatedly subjected to minor trauma over and over again. This is what happens when you are a sedentary politician and all of sudden decide to train for a dancing competition for hours a day. Mr. Delay has what he is calling a pre-stress fracture, meaning that there is some swelling noted around the bone, but it is not fractured. If he continued with the amount of training he had been doing, he would likely end up with a stress fracture.
Stress fractures are often described as pin-point pain usually in the bones of the ball of the foot. These bones are called metatarsals and they are long and skinny. They tend to break at the neck of the bone. Along with pain, there is usually warmth, swelling and redness at the sight. Stress fractures are treated with rest, immobilization in a cast or cast boot, anti-inflammatory pills for pain and mostly time. Stress fractures take about 6 weeks to heal.
Mr. Delay is going to limit his dancing and wear more rigid shoes to help take the stresses off of his feet. This should limit the damage but I would not bet on him going all the way in the competition.
If you enjoy dancing, go right ahead. It is great exercise and a lot of fun, just try not to over do it. If you do and you feel pain in your foot you should see your podiatrist immediately. If you catch a stress fracture early you can limit the damage.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com

Triple Play

2009-09-08T07:42:00.000-07:00

Being baseball season, I think the triple play analogy works well for treating fungus toenails.....treat the nails, treat the skin and treat the shoes.

As most of you know, it can be very difficult to cure fungus toenails. And once you do clear the nails of the fungus, there is a chance of recurrence. So I propose that you not only treat the nails whether using topical, oral or laser but also treat the skin and the shoes. Treat the skin, the entire foot as well as web spaces, with a topical anti fungal cream twice daily along with proper bathing, helps reduce the chance of reinfecting the nails. And don't forget to treat the shoes. Your shoes are a perfect breeding ground for fungus. We recommend using a product, Mycomist, which kills the fungus in the shoes. I don't know of anyone who would argue against a triple play.

Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com

Labor Day and Your Feet

2009-08-31T06:12:00.000-07:00

This weekend is Labor Day, that annual bookmark reminding us that Summer is over and football season is about to start. Here in beautiful Sarasota, Florida, it is a welcome sign that cooler days are ahead. Labor Day also just happens to be a great excuse to go to the beach and cook food on the grill.
Be smart and wear sandals or water shoes to protect your feet when at the beach. I know the title of my last blog may scare people away from flip flops, but the reality is you can get hurt much worse by being barefoot. I will never forget the Labor Day cook out we had at my house as a kid some 20 years ago. After all the food was done my father cleaned the grill and placed the inner metal part of the grill on the ground to dry off. My cousin, who coincidentally is also a podiatrist today, accidentally stepped on the grill and burned his foot.
This may sound like a freak accident, at it was to a degree, but it makes a good point. We are used to wearing shoes and not being overly concerned about where we walk. If you are going to spend any extended amount of time barefoot, like a Labor Day cookout or surfing in Costa Rica (see prior blog) you just have to heighten your situational awareness. Add to this sun exposure and alcohol consumption and you can really get into trouble. I am not trying to be a buzzkill. I love the beach and cook outs. I will be at one for sure. I just want everyone to be safe. Wear shoes whenever you are not in the water. Put sunscreen on the top of your feet. Limit your alcohol consumption and just generally be aware.
You never know when your crazy uncle is going to clean the grill and put in on the ground to dry off!

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com

Can Your Flip Flops Kill You?

2009-08-19T08:05:00.000-07:00

Don't you love sensational headlines like the title of this blog? I took that little gem right off the front page of a major Internet news source. I know there is a lot of news out there and they are trying to get our attention, but this useless scare tactic just bothers me. The simple answer is "yes" your flip flop can kill you...just like about anything else in this world. The premise of the story is that flip flops collect germs. I know this is may be very hard to believe, but they do. You know, because you walk outside in them. Apparently they even contain bacteria that is found on your skin. Also an amazing and newsworthy story. One of these particular bacteria, Staphylococcus Aureus can make you sick. Well the truth is many of the bacteria that can make you sick live on your skin all the time. In fact, if you look at it on a cell by cell basis, there are more bacteria in us and on us then there are our own cells.
Let me explain a little further. There are many bacteria in our mouths, on our hands and in our stomachs. This bacteria is supposed to be there and actually helps us in various ways. If however, you have a cut on your skin and these bacteria get into your circulation you can get sick. If stomach bacteria pass in your waste and then you touch your eye or your mouth you might get sick. This is not news. We all know this. This is why good hygiene and hand washing is so important. We live in a dirty world. I hate to break it to you but your feet are dirty. Your shoes are even dirtier than your feet. Don't touch your feet or your shoes and then touch your eyes or mouth without washing your hands. This is the most basic advice that your mother ever gave you.
There is no need for the news to try to scare us, but they do. It is important that you inform yourself so you won't be scared unnecessarily. As far as flip flops go, they can be worn for limited time periods without any fear. They are not very supportive and if you have some foot issues they may get worse with extended use of flip flops. Use some common sense and wash your hands if you touch the bottom of your flip flop or any shoe for that matter.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com

Is Walking Barefoot Good For You?

2009-07-31T13:05:00.000-07:00

Living in Sarasota, Florida we really are spoiled. The beaches are so beautiful and the sand is amazing. I just got back from a few days in Costa Rica. The country really is naturally beautiful but the beach consists of a muddy, black sand and rocks. Not exactly like Siesta Key. I also walked barefoot while climbing a mountain and then jumping into a waterfall. I know all of this sounds wonderful but I will tell you my feet hate me for it. You would think I would know better, I am a podiatrist after all, but I figured "when in Rome." You see, no one wears shoes in Costa Rica. My feet are cut, bruised and painful.
This reminded me of a question I hear all the time. "Isn't walking barefoot good for you?" The answer is a resounding, "NO!" There is no benefit to walking barefoot and in fact it can cause a host of problems. I will admit that primitive man did not have shoes so you could say that it is "natural" to be barefoot. Yes, but primitive man also did not have tile floor, cement, glass, metal and plastic debris all over the ground. Primitive man walked on the soft soil. Besides, just because something is not "natural" doesn't make it bad. Do you think it is "natural" to wear glasses?
The human life span has increased from somewhere in the teens to somewhere in the 70's if you are an American. That is a huge difference in mileage walked. The surfaces have changed, our weight has drastically increased on average. The point is that while barefoot walking may seem like a normal thing to do, it is no longer practical. Wear shoes when you are active and outside. Your feet will be glad you did. If you are looking for the right shoe for you refer to my earlier blog about picking the right shoe. Proper shoe gear can make a huge difference between cut, bruised, painful feet and healthy, painless feet.

Committed to you health,

Dr. Craig Conti, DPM
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com

New Therapy for People Suffereing With Neuropathy

2009-06-26T11:22:00.000-07:00

According to some recent studies, 66% of diabetics have some form of neuropathy. Neuropathy is a condition that affects the nerves. It causes numbness, tingling, loss of balance and in about 10% of cases pain. Those people who have suffered with painful diabetic neuropathy have only a few treatment options. There are several pills that can treat neuropathic pain with differing levels of success, but none of them increase sensation or improve balance.
Recently, a new therapy has been used on neuropathy. This therapy is called electric stimulation or just e-stim for short. The benefits of this therapy are many. First, this is not a medication so it does not interfere with any medications the patient is already on. Second, not only does the therapy decrease pain but it also improves sensation and restores balance.
E-stim is available in the office setting and it is covered by major insurance plans including Medicare.
The therapy takes a hour per session and it is delivered in our comfortable treatment room equipped with a television and reading materials. A total of thirty sessions must be completed for maximal effectiveness. The treatment is painless.
If you have neuropathy, with or without diabetes you should seriously consider e-stim therapy as a safe effective treatment.

Committed to your health,

Dr. Craig Conti

Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com

Buying the Proper Shoes for You

2009-05-08T06:32:00.000-07:00

Feet are prone to more injury than any other part of the body according to the American Podiatric Medial Association (www.apma.org). One good way to limit these injuries is to wear properly fit shoes. I am often asked, "What is a good shoe?" This is an impossible question to answer. The question really is, "What is a good shoe for my particular foot for the particular activity I plan on doing." Now that is a much easier question to answer. Specific sports require different things of your feet. Running is all about impact, the constant pounding in a vertical direction. Tennis is more about quick stops and starts and lateral movements. Bottom-line, different activities require different shoes.

Here are some simple, common sense tips to help you choose a "good" shoe.

Have your feet measured while you’re standing.

Always try on both shoes, and walk around the store.

Always buy for the larger foot; feet are seldom precisely the same size.

Don’t buy shoes that need a “break-in” period; shoes should be comfortable immediately.

Don’t rely on the size of your last pair of shoes. Your feet do get larger, and lasts (shoemakers’ sizing molds) also vary.

Shop for shoes later in the day; feet tend to swell during the day, and it’s best to be fitted while they are in that state.

Be sure that shoes fit well—front, back, and sides—to distribute weight. It sounds elementary, but be sure the widest part of your foot corresponds to the widest part of the shoe.

Buy shoes that don’t pinch your toes, either at the tips, or across the toe box.

Try on shoes while you’re wearing the same type of socks or stockings you expect to wear with the shoes.

If you wear prescription orthotics—biomechanical inserts prescribed by a podiatric physician—you should take them along to shoe fittings.

My best advice if you are planning to start a new exercise program is to invest in a new pair of shoes. Go to a store that specializes in athletic shoes. I recommend a store like Fleet Feet (www.fleetfeetsports.com) if they are in your area. The knowledgeable staff do a very good job with fitting and they can guide you to a sport specific shoe.
Remember, you would not start a new sports activity without the right equipment and shoes are big part of that.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com

If You Are On Blood Thinners You Should Not Cut Your Own Toenails

2009-04-16T11:41:00.001-07:00

There are many blood thinners on the market. Aspirin thins the blood but that is not what I am talking about here. I am talking about a group of medications that are used for no other purpose then to slow the clotting of blood. The medications I speak of are: Coumadin, Warfarin, Lovenox and Heparin. If you are on one of these drugs you should not cut your own toenails due to increased risk of bleeding events if your accidentally cut yourself.
In fact, Medicare and most other insurances cover the routine care of nails and calluses every 9 weeks by a foot doctor, if you are on these specific medications.
There are many reasons to be on blood thinners. Joint replacements, heart valve replacements, blood clots, atrial fibrillation (a heart problem) and cancer are just a few of the conditions that cause patients to take these medications.
The way you know if you are on one of these medications is very simple, do you have to check your INR? INR is international normalization ratio, and it is a number that helps patients on blood thinners to know if their blood is too thin or not thin enough. If you have your INR checked, you should not be cutting your own nails. Contact your local foot doctor to have an evaluation and set up a regular schedule to have the foot care you need done safely.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com/

American Diabetes Association Changes Guidlines

2009-04-16T11:14:00.000-07:00

Diabetes is one of the biggest medical issues facing this country and it is only getting worse. One in 3 Americans born after the year 2000 will develop diabetes at some point in their life. The direct and indirect costs of diabetes are absolutely enormous.
Feet and legs are disproportionately affected by diabetes. In fact, diabetes is the number one, non-traumatic cause of leg and foot amputations, accounting for 60,000-80,000 amputations per year. Patients living with diabetes are urged to have a diabetic foot screening with a local podiatrist at least annually. The two major systems the foot doctor will access are the blood flow and nerve systems. We know that any problems with these systems dramatically increases your risk for ulceration and ultimately amputation of the foot and leg.
In order to help catch issues with the blood flow system earlier and ultimately prevent amputation, the American Diabetes Association (ADA) has changed their guidelines on blood flow testing. The ADA now recommends that all diabetics over the age of 50 have a blood flow test at least once every 5 years. This test is painless and is very similar to getting your blood pressure taken with an inflatable cuff.
If you are a patient living with diabetes and you have not had a blood flow test in 5 years or more, please alert your foot doctor or your primary care doctor. By having this painless test done you can help to protect yourself and the people you care about from major complications, including amputation.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com/

No Need to Suffer with Neuropathy Alone

2009-03-24T10:37:00.000-07:00

Do your feet tingle and burn, usually worse at night? Do your feet feel numb? Do you feel like your balance is off recently? If the answer to any of these questions is "yes" you may have peripheral neuropathy. Neuropathy is a condition affecting millions of Americans. The most likely cause of neuropathy is Diabetes. If you are not diabetic other causes include chemotherapy drugs, low back injury or surgery, or exposure to certain chemicals. If none of these apply we call it idiopathic, which is the medical term for, "we don't know the cause." Approximately 15-30% of all cases of neuropathy are idiopathic.
Due to the complex nature of the disease and the varying ways it affects people the treatments can be very varied. Also, the best care for this is by a team of doctors, including a neurologist, an endocrinologist, pain management doctor, back doctor and of course a podiatrist. This complicated system, with many different doctors giving patients a lot of different advice, can lead to confusion.
A new support group has started at the Magnolia Health Center, located at 1507 S. Tuttle Ave. to help sort out all of this confusion. I had the opportunity to speak to this dynamic and informative group. I was there to teach but I think I learned more than anyone else. It was fascinating for me to listen to patients discuss all the difficulties they have had with this disease. They discussed the multitude of doctors, the frustration, the joys of treatments that finally helped.
Anyone suffering from peripheral neuropathy should know you don't have to go through it alone. The meetings are held the 3rd Friday of every month at the Magnolia Health Center, located at 1507 S. Tuttle Ave.
Don't forget that if you do have neuropathy you should not be cutting your own toenails. Your insurance will cover nail care for you. You should also check your feet daily for any redness, swelling, wounds or blisters. These can be signs of serious issues but without pain you may not notice them.
In the end, a neuropathic patient must be very aware of their feet and use their eyes and their mind to compensate for the loss of sensation.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com/

Do You Want Feet Like Your Grandmother?

2009-01-26T06:38:00.000-08:00

There are so many wonderful things your parents can pass on to you: stocks, fine china, a condo at the beach...but what about bunions? Yep, that is right, bunions. An enlarged, boney bump on the big toe side of the foot, that can cause pain and difficulty fitting in shoes, is called a bunion. I know what you are thinking..."aren't those caused by shoes?" The answer is no. Bunions or hammertoes (contracted, arched toes) are not CAUSED by shoes. Now the symptoms, (meaning redness, pain etc.) can be worsened by ill-fitting shoes, but the cause is something much less preventable.
Genetics determine our hair color, eye color and the way we walk, among other things. If you just so happen to be made with a flatter foot you increase your chances for developing hammertoes and bunions in the future.
So what can you do to avoid having feet like your grandmother? Are you doomed? No, you are not doomed. There are things that you can do to slow the process and treat it if you already have the signs and symptoms of these conditions. There are devices called orthotics, (custom molded shoe inserts that are provided by a foot doctor) that can change the way you walk and thereby limit or even prevent hammertoes and bunions. Wearing shoes that do not cause increased friction and rubbing on the toes and joints will help to limit your pain, but it will not slow this process down in any way. Finally, surgery is the treatment IF you have bunions and hammertoes that are painful for you everyday. Only you and your foot doctor can decide what is best for you and your feet.
As far as your grandmother is concerned, give her a call, she misses you!

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com/

Don't Let Foot Pain Stop Your New Year's Resoloution

2009-01-02T05:59:00.001-08:00

Happy New Year! Now is a time of new beginnings. A time when we all look at our lives and try to make things better for next year. It also happens to be the end of the holiday season. A season that, on average, leads to 9 pounds of weight gain due to excessive holiday treats.
One of the most common New Year's resolutions is to lose weight. I know I have made that resolution a few times myself. With 2/3 of the American population overweight, there is a good chance that you, or someone you know will resolve to lose some weight this year. One of the keys to any sensible weight lose program is aerobic exercise. For most of us this means walking, jogging or something of the sort. If you have not been exercising for a while and all of a sudden start a major work out campaign you can cause some serious foot pain. Don't let foot pain stop you from achieving your weight loss goals.
Tendonitis, heel pain and even stress fractures are very common in people who start a new work out program or who have recently increased their activity drastically. Be smart, start off gradually. Remember the story of the tortoise and the hare? Weight loss is a long process. You can't loose all the weight in one really long, hard run. I promise, I have tried it and it does not work. Start with 15 minute increments. You are going to be sore, but there is a big difference between sore and injured. Stretch out before and after you exercise and drink plenty of water to stay hydrated. Make sure you are wearing the proper shoe gear for your activity. You would not start a tennis program without a racket and you should not start a running program without a quality pair of running shoes.
If you have sharp pain in your feet or legs during exercise, stop. Don't try to run through the pain. If you have pain in your feet or legs that is beyond the usual muscle soreness call a podiatrist and have the problem evaluated.
Protect yourself and think long term. Remember, life is a marathon not a sprint! Good luck with your resolutions and I will see you in the gym.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com/

Do You Really Get Warts From Frogs?

2008-12-19T10:27:00.000-08:00

Warts are a very common skin condition that affects the feet. Kids and teens are the most likely group to get warts but they can occur at any age. There is much confusion and folklore out there about what causes warts and how you can cure them. First of all, warts are not caused by frogs, toads or amphibians of any kind. Warts are caused by a virus, specifically the human papilloma virus. This microscopic virus enters the body through tiny cuts in the skin of the foot. Most of the time, our immune system destroys the virus and you never show any symptoms. Some times, the virus is not destroyed. It instead takes over skin cells and produces more and more virus.
A wart on the bottom, or plantar, part of the foot is called a plantar wart. This is not to be confused with the word planter. Make no mistake, warts are not related to or caused by any type of farming or gardening. Plantar warts are raised, have a rough surface and often contain small black dots. These black dots are actually blood vessels that have been taken over by the virus cells and have now grown so fast that they clot off. Because of this unique property warts can bleed easily if scratched or rubbed. Warts are sometimes painful and sometimes painless. It all depends on the thickness of the wart and the location. Skin on the bottom of the foot is very thick and makes treatment of warts difficult.
Medical science is not very good at killing viruses. This is why the common cold and HIV are so difficult to treat. The way warts are treated is by destroying the virus and the skin that it lives in. We do this in various ways. Sometimes freezing the skin is the treatment, other times it is through the use of chemicals such as acids. Either way the treatment of warts is a slow process that takes several weeks.
What if you never treat them? Well, there is a very complicated interplay of the virus and our immune system. Warts do just seemingly disappear on occasion. Why is this? This happens because the immune system can clear the virus by itself. This is very unpredictable and is the reason we treat warts to help speed the process up. This spontaneous healing of warts has lead people to believe that all manner of home remedy is actually responsible for the effect. I have heard of people putting soap under the mattress or burying a potato in the backyard to help with warts. I assure you, this does nothing to the virus, but the power of the mind is very strong.
I think of it like the Indian rain dance. Do you know how that worked? Well, they just kept on dancing until it rained. Hopefully it didn't rain frogs or else they all might have broken out with warts! Just kidding, see how these crazy stories are spread.

Commited to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com/

Beware of Holiday Foot

2008-12-08T06:32:00.000-08:00

It is that time of year again. The time when cookies and snacks are everywhere. It is the holiday season. The winter holidays are a great way to stay cheerful during the dark, cold part of the year. One mainstay of the holiday season is sweets. We all indulge a little. What harm can it do? Well if you are a person living with diabetes it can be a very dangerous time of year. First, the increase in caloric consumption with the addition of many sugary desserts can throw glucose control out of whack. Second, parties and family gatherings may inspire you to wear a new pair of shoes or a seldom worn pair of dress shoes.
This confluence of events can lead to a wound that will ultimately go on to ulceration. The foot of a diabetic person is a very fragile one. With the decreased sensation and blood flow that often mark the disease, ulcerations form and are very hard to heal. The very best treatment is prevention. How can you prevent yourself or someone you love from getting into trouble with their feet this holiday season? The most important thing is to be aware. Check your feet daily. Look for any red spots, cuts or calluses that were not there the day before. If you are wearing a new pair of shoes check to make sure they are not causing any calluses or blisters. If you have any questions or concerns don't hesitate to contact your podiatrist. Early detection and treatment are of critical importance in this matter. Don't wait until after the holidays to take care of yourself! Oh yeah, go easy on the desserts, you will be glad you did when those New Year's resolutions come around.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com/

The Future is Bright for Those with Drop Foot

2008-11-26T08:28:00.000-08:00

There is some very exciting news in the world of paralysis of the foot and leg. A condition called drop foot, a weakness of the muscles used to raise the foot and toes, can be the result of many different neurological problems. These problems include stroke, spinal cord injury, multiple sclerosis and others.
A new device called the Bioness L300 is a wireless device that attaches to the knee and the ankle and helps to move the foot using electrical impulses. The results have been startling. People who have struggled for decades are finally able to walk without braces or restrictions. This allows the patients to have more freedom and independence of movement. The new device also limits tripping and falling significantly, which is a big risk with a drop foot.
The Bioness L300 is still in very limited use at this time. The cost of the device is very serious drawback. The cost is around $6,000. That is the bad news. The good news is that as the technology improves the cost per unit will go down and in the near future the devices could be available for a much more reasonable price.
For those of us who grew up watching the Bionic Man it is so exciting to see technology helping solve some very complicated medical conditions.
The future is very bright.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com/

Ankle Injury Sidelines TB Player

2008-11-19T10:39:00.000-08:00

"Tampa Bay Buccaneers leading rusher Earnest Graham will miss the rest of the season after injuring his right ankle during last week's victory over the Minnesota Vikings. Graham limped off the field after his only carry against the Vikings. The Bucs said he hurt his ankle, but did not release specifics about the injury. Fourth-year pro Noah Herron was signed to fill Graham's spot on the roster." This was reported by Fox Sports. It appears that this was fairly significant injury to his ankle to put him out for the remainder of the season. As with any ankle injury, prompt diagnosis and treatment are critical for the outcome. Through the use of xray the bone structures can be evaluated to rule out fractures or breaks. MRI are often used to diagnose torn or stretched ligaments and tendons. Treatment can be as simple as RICE (rest, ice, compression, elevation). Use of crutches to offload the injury can be very helpful. Inaddition, proper bracing can be used to speed recovery and prevent future injury.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com/

Broken Foot in a Hockey Player

2008-11-14T11:58:00.000-08:00

Hockey players are tough. You have to be tough to play a game where getting hit with a stick or a puck is just part of the job. I have seen hockey players getting their faces stitched up on the bench and then return to the game but I was very surprised to hear about Vancouver Canucks defenceman Kevin Bieksa. This guy suffered a broken foot bone when he was hit with a puck off the stick of one of his own teammates. The report is that he is likely to miss only ten games. That is amazing! Broken foot or toe bones take 6 weeks to heal. I don't care if you are a hockey player or not. This means that he will most likely be skating on a partially broken bone for up to a month.
Broken bones in the feet are very common. Twisting injuries, collisions with furniture and dropping things on your foot are just a few ways to cause this type of injury. If you injure your foot you should immediately get off of the foot and ice and elevate the limb. This is to decrease swelling. If the pain is severe or if it continues for more than a few days you should see your podiatrist or go to the emergency room. An x-ray is the only way to tell if the bones are truly broken. Many people believe that nothing can be done about a broken toe, but this is false. Splinting and protection in a special type of shoe is very important to insure proper healing and prevent possible arthritis in the future. If you come to see me with a broken foot I will put you in a protective boot and have you rest, ice and elevate the limb. I will also tell you no ice skating for 6 weeks...even if you are a hockey player!

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com/

Veterans Day and How an Ingrown Toenail Can Save Your Life

2008-11-12T08:18:00.000-08:00

Veterans day has come and gone without much fanfare. I think is very easy for us to forget what our service men and women do for all of us, everyday, to ensure our freedoms. I had the great pleasure of taking care of a Vietnam veteran recently in the office. He had an ingrown toenail. For those of you who have not had one, believe me it is very painful. In fact, ingrown toenails are near and dear to my heart. If it had not been for the one I had when I was ten I don't know if I would be a podiatrist in Sarasota today. I was relaying this story to my new patient when he said he had a much better story about ingrown toenails. In fact, he said an ingrown toenail had saved his life. Well he certainly had my attention. As the story goes he was a member of a Ranger Team that was in a forward position. They had gone a few days without anything happening so my patient decided to go back to the base to get his first ever ingrown toenail taken care of. He was tired of walking around in heavy boots with a red, swollen, painful toenail. He was also worried about the pus that was draining out of the toe. He went back to the base for his needed care and while he was gone his entire team was ambushed. There were no survivors.
The next time you have a very painful, red, swollen, toenail I hope you get the proper medical attention you need. I also hope that you take a moment and thank every veteran you know for what they have done and continue to do so we can live with freedom.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com/

Community Project: Shoes for the Needy

2008-11-12T07:17:00.001-08:00

Sarasota Foot Care Center has started their shoe drive for the needy. We will be collecting slightly worn/used athletic shoes which will be given to the local Salvation Army Center. They will then distribute the shoes to the individuals in need. Currently the drop off location is at the main office of Sarasota Foot Care Center, 1921 Waldemere Street, Sarasota. Other sites will be available in the near future and we will keep you posted of their location. Thank you for helping with the worthwhile much needed project.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com/

Midfoot Sprain for Portland Trailblazers Rookie

2008-10-29T10:37:00.001-07:00

The NBA season has just started and already the Portland Trailblazers are dealing with an injury to their highly anticipated rookie. Greg Oden, the first overall draft pick last year, missed his entire first year due to an injury of his knee. Last night he started his very first NBA game with much hype and excitement. He left the game against the L.A. Lakers in the first half, going scoreless on 4 shots. The reason he left is a foot injury. X-rays were taken and were negative for fractures. The injury is being called a mid-foot sprain and an MRI is scheduled for later this week.
Each human foot contains 28 bones, 33 joints and over one hundred ligaments. The x-ray showed no broken bones but it can not be used to evaluate the many ligaments and tendons in the foot. An MRI is a specialized imaging study that can detect stretched and torn ligaments that can be found in a mid-foot sprain. This is a very common sports injury and it happens in tennis, football, basketball and volleyball to name a few. In basketball it often occurs when a player jumps up and then lands on the foot of another player. This causes a twisting movement at the foot and stretches or tears the ligaments of the foot.
A mid-foot sprain presents as tenderness, swelling and pain usually following a traumatic twisting event. Some people are able to walk following the injury and others are not. Initially the sprain should be treated with rest, ice, compression and elevation. The is commonly called RICE therapy by athletic trainers and sports doctors. If the pain and swelling are not significantly better using RICE therapy after a few days you should consult a podiatrist.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://http://www.sarasotafootcarecenter.com/

Athlete Has Partial Foot Amputation because of MRSA Infection

2008-10-18T13:29:00.000-07:00

It has been reported that 7'7'' UNC Asheville basketball player, Kenny George, had a partial amputation of his foot because of MRSA infection. He developed this infection while at a basketball camp during the summer. It appears that even with early treatment that this aggressive infection could not be controlled with antibiotics along and required the surgery to remove infected tissue and bone. It has not been reported as to how much of Kenny's foot was amputated so it is hard to tell his recovery and potential to play basketball.

MRSA stands for methicillin-resistant Staphylococcus aureus and is transmitted through skin-to-skin contact through openings in the skin. The usual antibiotics used to treat staph infections do not kill off this stain of bacteria and typically requires IV antibiotic of Vancomycin. When the infection is aggressive, the surrounding tissue, skin, tendon, and bone, "dies" requiring surgery to remove it which may include partial or total amputations.

As with any infection, timely evaluation and treatment are of most importance. When ever you develop redness, soreness, drainage, and heat of any area, seek medical treatment promptly.

Dr. Conti on TV!

2008-10-16T05:29:00.001-07:00

Dr. Craig Conti was interviewed on WWSB-TV Sarasota on the recent injury of Misty May Trainor. Here is the link to his interview with Heidi Godman. http://www.mysuncoast.com/global/story.asp?s=9171955

Welcome

2008-10-16T04:54:00.000-07:00

Welcome to the Sarasota Foot Care Center blog. We will be posting information about foot and ankle care along with stories to help improve your health and active lifestyle. Send your comments and questions and we will try to answer as many as possible.