What Is A Podiatrist?

A podiatrist is a doctor of podiatric medicine. This doctor will provide medical diagnosis and treatment of many kinds of foot and ankle problems, anything from bunions, heel pain, bone spurs, hammertoes, neuromas, ingrown toenails, warts, corns and calluses and many more. A podiatrist also renders care of sprains, fractures, infections, and injuries of the foot, ankle and heel. In addition to undergraduate medical school training, podiatrists must also attend graduate school for a doctorate degree in podiatry. Podiatrists are required to take state and national exams, and they must be licensed by the state in which they practice.
According to the American Podiatric Medical Association, there are an estimated 15,000 practicing podiatrists in the United States. Podiatrists are in demand more than ever today because of our rapidly aging population. Foot disorders are among the most widespread and neglected health problems affecting people in this country.
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Typically, podiatrists will:
  • Consult with patients and other physicians on how to prevent foot problems.
  • Diagnose and treat tumors, ulcers, fractures, skin and nail diseases, and deformities.
  • Perform surgeries to correct or remedy such problems as bunions, clawtoes, fractures, hammertoes, infections, ruptured Achilles, and other ligaments and tendons.
  • Prescribe therapies and perform diagnostic procedures such as ultrasound and lab tests.
  • Prescribe or fit patients with inserts called orthotics that correct walking patterns.
  • Treat conditions such as: bone disorders, bunions, corns, calluses, cysts, heel spurs, infections, ingrown nails and plantar fasciitis.

What Are Some Common Foot Problems?

Foot and ankle problems usually fall into the following categories:
  • Acquired from improper footwear, physical stress, or small mechanical changes within the foot.
  • Arthritic foot problems, which typically involve one or more joint.
  • Congenital foot problems, which occur at birth and are generally inherited.
  • Infectious foot problems, which are caused by bacterial, viral, or fungal disorders.
  • Neoplastic disorders, usually called tumors, which are the result of abnormal growth of tissue and may be benign or malignant.
  • Traumatic foot problems, which are associated with foot and ankle injuries.

The top foot problems are:

  • Achilles tendonitis involves inflammation of the Achilles tendon. If the tendon stays inflamed long enough, it can lead to thickening of the tendon. Sometimes nodules or bumps can form in the tendon. Achilles tendonitis can become a long term problem or can lead to rupture of the tendon.
  • Bunions - misaligned big toe joints that can become swollen and tender, causing the first joint of the big toe to slant outward, and the second joint to angle toward the other toes. Bunions tend to be hereditary, but can be aggravated by shoes that are too narrow in the forefoot and toe. Surgery is frequently performed to correct the problem.
  • Corns and callouses are areas of thick, hard skin. They usually develop due to rubbing or irritation over a boney prominence. The hard, thick skin is called a corn if it is on your toe and it is called a callous if it is somewhere else on your foot.
  • Flat feet : Just because you have flat feet does not mean you will have problems or pain. If you do have pain, there are various treatment options available. If you only have one foot that has a flat arch, it may be due to another problem and you should get it checked out.
  • Hammertoe - a condition, usually stemming from muscle imbalance, in which the toe is bent in a claw-like position. It occurs most frequently with the second toe, often when a bunion slants the big toe toward and under it, but any of the other three smaller toes can be affected. Selecting shoes and socks that do not cramp the toes will alleviate aggravation.
  • Heel Spurs - growths of bone on the underside, forepart of the heel bone. Heel spurs occur when the plantar tendon pulls at its attachment to the heel bone. This area of the heel can later calcify to form a spur. With proper warm-up and the use of appropriate athletic shoes, strain to the ligament can be reduced.
  • Ingrown Toenails - toenails whose corners or sides dig painfully into the skin. Ingrown toenails are frequently caused by improper nail trimming, but also by shoe pressure, injury, fungus infection, heredity and poor foot structure. Women are much more likely to have ingrown toenails than men. Ingrown nails can be prevented by trimming toenails straight across, selecting proper shoe style and size – not too tapered or shallow – and paying special attention to foot pain.
  • Neuromas - enlarged benign growths of nerves, most commonly between the third and fourth toes. They are caused by tissue rubbing against and irritating the nerves. Pressure from ill-fitting shoes or abnormal bone structure can also lead to this condition. Treatments include orthoses (shoe inserts) and/or cortisone injections, but surgical removal of the growth is sometimes necessary.
  • Plantar Fasciitis (Heel Pain) - usually caused by an inflammation on the bottom of the foot. Our practice can evaluate arch pain, and may prescribe customized shoe inserts called orthoses to help alleviate the pain.
  • Plantar warts are caused by a virus. Plantar means bottom of the foot, but warts can occur other places on the foot and toes as well. Plantar warts can be painful depending on where they are located. Sometimes they are mistaken for callouses because layers of hard skin can build up on top of the wart.
  • Sesamoiditis - inflammation or rupture of the two small bones (sesamoids) under the first metatarsal bones. Proper shoe selection and orthoses can help.
  • Shin Splints - pain to either side of the leg bone, caused by muscle or tendon inflammation. It is commonly related to excessive foot pronation (collapsing arch), but may be related to a muscle imbalance between opposing muscle groups in the leg. Proper stretching and corrective orthoses (shoe inserts) for pronation can help prevent shin splints.
  • Stress Fractures - incomplete cracks in bone caused by overuse. With complete rest, stress fractures heal quickly. Extra padding in shoes helps prevent the condition. Stress fractures left untreated may become complete fractures, which require casting and immobilization
  • Toenail fungus: Fungi like a warm, moist and dark environment (like inside a shoe). A fungal infection in your toenails may cause the nails to become discolored, thickened, crumbly or loose. There are different causes and it is difficult to treat due to the hardness of the toenail.

What Are Some Diabetic Foot Problems?

According to the American Diabetes Association, about 15.7 million people (5.9 percent of the United States population) have diabetes. Nervous system damage (also called neuropathy) affects about 60 to 70 percent of people with diabetes and is a major complication that may cause diabetics to lose feeling in their feet or hands.
Foot problems are a big risk in diabetics. Diabetics must constantly monitor their feet or face severe consequences, including amputation. With a diabetic foot, a wound as small as a blister from wearing a shoe that’s too tight can lead to a lot of damage. Diabetes decreases blood flow, so injuries are slow to heal. When a wound is not healing, is at risk for infection and infections spread quickly in diabetics.
When a diabetic foot becomes numb, it may be at risk for deformity. One way this happens is through ulcers. Small, unattended cuts become open sores, which may then become infected. Another way is the bone condition Charcot Foot. This is one of the most serious foot problems diabetics face. It warps the shape of the foot when bones fracture and disintegrate, and yet, because of numbness there is no pain, and the individual continues to walk on the foot. Our practice can treat diabetic foot ulcers and early phases of Charcot (pronounced “sharko”) fractures using a total contact cast and prevent more serious damage or deformity. This treatment allows the ulcer to heal by distributing weight and relieving pressure. For Charcot Foot, the cast controls foot movement and supports its contours. 
If you have diabetes, you should inspect your feet every day. Look for puncture wounds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, cuts, and nail discoloration. Get someone to help you, or use a mirror.
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Here’s some basic advice for taking care of diabetic feet:
  • Always keep your feet warm.
  • Don’t get your feet wet in snow or rain.
  • Keep feet away from heat (heating pads, hot water pads, electric blankets, radiators, fireplaces). You can burn your feet without knowing it. Water temperature should be less than 92 degrees. Estimate with your elbow or bath thermometer (you can get one in any store that sells infant products).
  • Don’t smoke or sit cross-legged. Both decrease blood supply to your feet.
  • Don’t soak your feet.
  • Don’t use antiseptic solutions (such as iodine or salicylic acid) or over-the-counter treatments for corns or calluses.
  • Don’t use any tape or sticky products, such as corn plasters, on your feet. They can rip your skin.
  • Trim your toenails straight across. Avoid cutting the corners. Use a nail file or emery board. If you find an ingrown toenail, contact our office for treatment.
  • Use quality lotion to keep the skin of your feet soft and moist, but don’t put any lotion between your toes.
  • Wash your feet every day with mild soap and warm water.
  • Wear loose socks to bed.
  • Wear warm socks and shoes in winter.
  • When drying your feet, pat each foot with a towel and be careful between your toes.
  • Buy shoes that are comfortable without a “breaking-in” period. Check how your shoe fits in width, length, back, bottom of heel, and sole. Avoid pointed-toe styles and high heels. Try to get shoes made with leather upper material and deep toe boxes. Wear new shoes for only two hours or less at a time.
  • Don’t wear the same pair of shoes every day. Inspect the inside of each shoe looking for foreign objects, protruding nails, or any rough spots inside before putting them on. Don’t lace your shoes too tightly or loosely.
  • Choose socks and stockings carefully. Wear clean, dry socks every day and always wear socks with shoes. Avoid socks with holes or wrinkles. Thin cotton socks are more absorbent for summer wear. Square-toes socks will not squeeze your toes. Avoid stockings with elastic tops or garters.
  • Never wear sandals or thongs (flip-flops) and never go barefoot, indoors or out.
  • In the winter, wear warm socks and protective outer footwear. Avoid getting your feet wet in the snow and rain and avoid letting your toes get cold.
  • Don’t file down, remove, or shave off corns or calluses yourself.
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Contact our office immediately if you experience any injury to your foot. Even a minor injury is an emergency for a patient with diabetes.