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Steven Shlonsky, DPM
149 Thierman Ln
Louisville, KY 40207
(502) 897-6343 We make house calls
July 2022
Tuesday, 26 July 2022 00:00

Foot and Ankle Trauma

Broken Feet

A broken foot can either refer to a fracture or a straight break. The location of any break can tell you how the break happened. Toes, for instance, break typically as a result of something being kicked hard and with great force. Heel breaks almost always are a result of an improper landing from a tall height. Twists or sprains are the other two frequent occurrences. As with all usual breaks, they result from unexpected accident or sudden injury. As with stress fractures, breaks form as a process over time from repeated stress on already present cracks. Runners, dancers, and gymnasts are the usual athletes who receive this type of break. Stress fractures result from incredible pressure on the feet. It is no surprise these athletes bear the majority of reported fractures.

Pain, swelling, bruising, and redness are all indicative of the typical symptoms from a broken foot. Severe pain—to the point of not being able to walk—usually depends on the location of the break in the foot. Toes are on the lower scale of pain threshold, but heels are high, as are a few other particular bones. As the severity of the broken foot increases, symptoms like blueness, numbness, misshaping of the foot, cuts, or deformities will become apparent. These symptoms indicate the need to see a medical professional with access to an x-ray facility.

Prior to seeing a specialist, precautions should be taken to reduce pain and swelling. Elevate and stabilize the foot, and refrain from moving it. Immobilization of the foot is the next priority, so creating a homemade splint is acceptable. Keep in mind that while creating a splint, any increase of pain or cutting off blood circulation means that the splint should be removed immediately. Use ice to decrease swelling and relieve pain symptoms.

When dealing with a medical center, the patient should note that the treatment can vary. The treatment will depend on the severity of the fracture and the cause of the break. Crutches, splits, or casts are common treatments while surgery has been known to be used in more severe cases in order to repair the break in the bones. 

Broken Ankles

Broken ankles are a serious injury that can lead to an inability to walk, function, and also cause a significant amount of pain. A broken ankle is a break in one of the three bones in your body that connect at the ankle joint, the tibia, the fibula, and the talus. The tibia and fibula are your two primary leg bones that connect at the knee, which sits directly upon the talus bone. This is protected by a fibrous membrane that allows for movement in our ankle joint. A broken ankle is usually caused by the foot rolling under or twisting too far, causing one of these three bones to snap.

A broken ankle is different from an ankle sprain, which occurs when the ligaments are ripped or torn but no bones have been broken. A sprain can still be very severe, causing bruising in the foot and an inability to hold your own weight, much like a broken ankle would. If you’re unable to stand, and suspect that you have a broken ankle, the first thing to do would be to get an immediate x-ray to determine the severity of the break.

A common cause of broken ankles is when the ankle is rolled over with enough pressure to break the bones. This usually happens during exercise, sports, or other physical activities. Another common cause is a fall or jump from a tall height.

One immediate treatment for pain relief is elevating the feet above your head to reduce blood flow to the injured area. You can also apply ice packs to your ankles to help reduce swelling, redness, inflammation, and pain. After these initial steps, getting a cast and staying off your feet as much as possible will aid in the recovery of the broken ankle. The less movement and stress the ankle has to endure, the more complete it will heal. A doctor can determine if surgery is needed in order to heal correctly. In these cases, an operation may be the only option to ensure the ability to walk properly again, followed by physical therapy and rehabilitation.

It is highly important to determine if surgery is needed early on, because a broken ankle can become much more severe than you realize. If not professionally treated, the broken ankle will inhibit your walking, daily functioning, and produce a large amount of pain. Treating your broken ankle early on will help prevent further damage to it.

Published in Featured
Tuesday, 19 July 2022 00:00

Cuboid Syndrome

Cuboid syndrome mostly affects athletes, although it can affect non-athletes too. It is also known as cuboid subluxation or cuboid fault syndrome.  This condition occurs when joints and ligaments near the cuboid bone of the foot are damaged, or when the cuboid bone itself is dislodged from its natural position. It is usually marked by pain on the outer side of the foot, which may be persistent or may come and go. Cuboid syndrome can be difficult to diagnose unless it becomes severe and more noticeable. Your doctor will likely ask questions about when the pain began and how long it has been present, and will put pressure on the cuboid bone to determine if that area is the origin of the pain.

Causes of Cuboid Syndrome

  • Any repetitive stresses placed on the foot due to athletic activities are a common cause of cuboid syndrome.
  • Although it develops over time, it is possible that this syndrome can occur all of sudden due to a single event or injury.
  • Over-pronation can exacerbate the condition if not corrected.

Disagreements Amongst Podiatrists Regarding Cuboid Syndrome

  • Some refer to it as the dislocation of the calcaneal-cuboid joint only.
  • Other podiatrists see it as an injury of the ligaments located nearby, which also involves the cuboid bone.

It is very important that when you experience any kind of pain on the side of your foot, you should seek medical care right away. If a subluxed cuboid is caught early, your feet may respond well to the treatment, and you can get back into sports or other activities again as soon as the pain subsides.

Published in Featured
Tuesday, 12 July 2022 00:00

Elderly and their Feet

While proper foot care is important for everybody, senior citizens have the tendency to be more susceptible to certain foot conditions. The elderly should therefore be well informed about any problems that may arise and about what they can do to properly avoid or treat them.

Some of the most common foot problems seniors are susceptible to include foot ulcers, ingrown toenails, fallen arches, and fungal nails. A foot ulcer is an open sore on the foot and can be a result of diabetes and decreased sensation in the feet. An ingrown toenail is defined as when the nail grows into the side of the toe. Fallen arches are indicated by the instep of the foot collapsing. A fungal nails is a condition that results in deformed and discolored toenails.

In order to avoid these conditions it is recommended that the feet be inspected by the patient on a regular basis. If these inspections are carried out routinely, there is a good likelihood that problems can be identified before they become severe, or can even be avoided altogether. If any abnormality is discovered, it is important that the individual consult a podiatrist for diagnosis and information on treatment options.

Proper foot hygiene is also important. Making sure that you always have clean, dry socks on can be a major deterrent to many different problems including bacterial infections, foot odor, and certain types of fungus. Wet feet are a major cause of many of these problems.  If your socks get wet, it is important to change them. Walking around in wet socks may not only lead to various infections, but can irritate the skin and result in a number of various complications. Clean, dry feet are less likely to be affected by fungal and other infections.

As people age, the fat present on your feet begins to deteriorate. The protective nature of this fat keeps the feet healthy by providing a barrier between your bones and the ground. This also aids in giving the skin on the feet a certain amount of elasticity. This is one factor that causes elderly people to develop some serious foot issues. Foot moisturizers can be helpful to avoid certain problems associated with this. However, water-based moisturizers do not work as well for elderly people as they do for the young. Instead, it is more effective to use an emollient instead. An emollient is effective because it binds the water in the foot, keeping it from becoming absorbed too readily which will result in dry skin. Emollients also have a special property called occlusion, which provides a layer of oil on the skin. This layer prevents the foot from drying up and can be very effective in treating dry skin disorders.  If you can keep the skin on your feet healthy, this will substantially reduce the number of foot problems you will encounter in old age.

Proper footwear is another way to keep feet healthy. Shoes that fit well and provide proper support help prevent ingrown toenails and fallen arches.

Certain medical conditions such as diabetes or poor blood circulation increase the risk for foot issues. For individuals with any of these conditions it is extremely important to conduct regular foot inspections to make sure that there are no sores or infections present.

Published in Featured
Tuesday, 05 July 2022 00:00

Sports Related Foot And Ankle Injuries

Foot and ankle injuries are common among people who participate in sports. Several factors contribute to this. They include failing to stretch or warm up properly, not wearing the proper type of shoe and not taping or providing other types of support for the ankle or foot. The most common foot and ankle injuries suffered by people involved in sports are plantar fasciitis, ankle sprains and Achilles tendon damage or ruptures. If not treated properly, they can lead to permanent disability.

Treating these injuries is relatively simple if they are identified and addressed early. Many athletes dismiss the initial aches and pains associated with injury as just soreness or tired muscles. Their first response is usually to try to work through it. This can lead to serious problems. Many minor injuries are made far more serious when athletes continue to put strain and pressure on them. That attitude can change a mild strain into a serious strain and a minor tear into a rupture. Athletes should have unusual aches and pains evaluated by a skilled medical professional.

Plantar fasciitis is a painful injury. It is inflammation of the plantar fascia, the thick band of tissue running from the heel to the base of the toes. If left untreated, it can lead to a degenerative disease called plantar fasciosis. There are several effective treatments for this ailment. Doctors often prescribe rest, massages, stretching, night splints, physical therapy, anti-inflammatory medication, corticosteroids or surgery, usually in that order. The most effective treatment for plantar fasciitis is orthotics, which offers foot support. Surgery is occasionally used as a last resort, but it comes with the risk of nerve damage and infection and often does not stop the pain.

The Achilles tendon is the largest tendon in the body. It connects the calf muscles to the heel bone. Running, jumping and walking all impact this tendon. Two common injuries to the Achilles tendon are tendonitis and a rupture of the tendon. Tendonitis is inflammation in the tendon often caused by an increase in the amount of stress placed on it. Non-surgical treatments include rest, ice or anti-inflammatory medication.  A rupture (tear) of the Achilles tendon can be treated by placing the lower leg in a cast for several weeks or with surgery. Many physicians feel surgery is the better option because it lowers the risk of re-ruptures. Both methods require 4 to 6 months of rehabilitation.

Ankle sprains are the most common sports related foot and ankle injury. A sprain occurs when the ligament holding the ankle bones and joint stretches beyond its normal range. It can be treated non-surgically with a combination of rest, ice wrapped around the joint for 30 minutes immediately after injury, compression by a bandage and elevating the ankle above the heart for 48 hours. This combination is referred to as RICE. Severe ankle sprains in which the ligaments are torn may require reconstructive surgery followed by rehabilitation.

Published in Featured