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Piriformis Syndrome and How Your Podiatrist Can Help

Friday, May 27th, 2011

If you are a regular reader of this blog, you already know that problems with the feet can lead to problems in the leg, thigh, lower back, and even the buttocks. The piriformis muscle is in the buttocks region. This muscle moves the thigh away from the body. A person can develop piriformis syndrome when the piriformis muscle irritates a large nerve in the buttocks region. This irritation causes pain in the buttocks, hips and groin. This pain can also extend to the thigh, leg, and foot. People with piriformis syndrome often have the following symptoms:

Chronic pain in the buttocks
Pain in the lower leg and foot that worsens with walking or squatting
Lower back pain
Pain when getting up from bed
Pain when sitting

Piriformis syndrome is usually caused by direct injury to the piriformis muscle. But, the way you walk can also cause piriformis syndrome. Overpronation is when a person walks with their knees turned inwards. This is also known as being “knock-kneed”. Walking with the knees inward for long periods of time overworks the piriformis muscle and can lead to piriformis syndrome.

If symptoms of piriformis syndrome are related to how you walk, your podiatrist can help. At Affiliated Foot & Ankle Center, LLP, we can create custom orthotics for your feet that help you walk in a more natural form. We can also discuss proper stretching exercises that will help lessen the pain associated with piriformis syndrome and which shoes will best help to prevent pain. Affiliated Foot & Ankle Center, LLP has locations at Howell, Edison, and Monroe, New Jersey.

Do you think you have piriformis syndrome? A talk with your podiatrist is a step in the right direction for getting relief from pain. We will work closely with your primary doctor to treat you in the best way possible. In the meantime, here are four suggestions that can help prevent pain caused by piriformis syndrome:

· Always do a warm-up activity before and during any sport or activity.

· After physical activity, be sure to give your muscles time to rest and recover. Do not overwork your muscles.

· Focus on activities that strengthen and condition the hips, buttocks and lower back.

· Stretch! Muscles that are flexible are less prone to injury.

After a long winter, don’t let pain keep you from enjoying the summer. Now is the time to get the proper care so that you can get the most out of life!

By Dr. Alison DeWaters

Tags: Affiliated Foot and Ankle Center, Dr. Alison Dewaters, howell, lower back pain, orthotics, Piriformis Syndrome
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Dr. Hal Ornstein To Be Inducted Into OCPM Hall Of Fame

Sunday, April 17th, 2011

(OCPM Press Release; 4/14/11) The Ohio College of Podiatric Medicine is proud to announce that Hal Ornstein, DPM, FASPS, OCPM Class of 1987, physician and managing partner at Affiliated Foot & Ankle Center, LLP in Howell, NJ, will be inducted into the OCPM Hall of Fame Society on Saturday, May 21, 2011 at the Glass Slipper Fete at the Embassy Suites Cleveland-Rockside Hotel in Independence, Ohio.

This year’s Glass Slipper Fete promises to be very exciting, as the Ohio College of Podiatric Medicine (OCPM) honors three alumni and inducts them into the OCPM Hall of Fame Society. The OCPM Hall of Fame Society is the highest honor given to an OCPM alumnus. The OCPM Hall of Fame Society is designed to recognize OCPM alumni who have demonstrated the highest moral and ethical values associated with podiatry, at least 20 years of dedicated service in the field of podiatry, and a strong appreciation of and loyalty to their alma mater, among other criteria.

Dr. Ornstein is recognized for his dedication to the podiatric profession, specifically his involvement in the American Academy of Podiatric Practice Management (AAPPM). Dr. Ornstein serves as an adjunct faculty member and coordinator for the four-year full curriculum practice management course at OCPM. In addition, Dr. Ornstein developed the first full practice management curriculum for three year residency programs; he is the physician coordinator of Student Chapters of the AAPPM. Dr. Ornstein was also a recipient of the Podiatry Management Magazine Lifetime Achievement Award.

In addition to Dr. Hal Ornstein, Dr. Terence B. Albright and Dr. William F. Munsey will also be inducted into the Hall of Fame Society.

Dr. Ornstein currently resides in Howell, NJ with his wife and two children. He has been in private practice for over 20 years and currently is the owner/Medical Director of Affiliated Foot & Ankle Center, LLP with locations in Howell, Edison and Monroe, NJ. To learn more about Dr. Ornstein, please visit www.footdoctorsnj.com or he can be found on Facebook (Affiliated Foot and Ankle Center, LLP) and Twitter (FootDoctorsNj).

One of nine podiatry schools in the nation, the Ohio College of Podiatric Medicine is dedicated to providing a comprehensive educational experience, enabling students to develop the skills, judgment, leadership and ethical values necessary to deliver quality podiatric medical and surgical care. Founded in 1916, OCPM has graduated over 6,000 podiatrists who have made outstanding contributions to the field and study of podiatric medicine.

Tags: Affiliated Foot and Ankle Center, Dr. Hal Ornstein, howell
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Valerie Gregory, MSPT, CKTP Discusses Kinesio Taping…

Sunday, March 20th, 2011

Kinesio taping is a dynamic rehabilitative taping method used by many physical therapists, chiropractors, and athletic trainers across the world. Kinesio tape was vastly advertised in the 2008 Beijing Summer Olympics, but it has been in production for 35 years. The Kinesio taping technique was developed by well know Japanese chiropractor Dr. Kenzo Kase in 1973 as a therapeutic taping technique offering patients and athletes the treatment they were looking for, but also rehabilitating the injury as well. Today, medical practitioners and high profile athletes around the world, such as professional volleyball player Kerri Walsh, seven-time Tour de France winner Lance Armstrong, professional tennis player Serena Williams, and international soccer star David Beckham, use Kinesio taping. It was officially introduced to the USA in 1997.

Kinesiology tape, also known as elastic therapeutic sport tape, is a cotton strip that has an acrylic adhesive used to treat assorted orthopedic, neuromuscular, neurological, and medical conditions. Mimicking the qualities of human skin, kinesio tape is applied and pulled to different degrees of tension depending on the desired effect and result. This non-restrictive taping technique facilitates full range of motion and can be used for reversing the effects of muscular facilitation or inhibition, carpal tunnel syndrome, low back strains, pain in a joint, knee conditions, muscle spasms, shoulder and elbow tendonitis, whiplash, plantar fasciitis (heel pain), patellar tracking, ankle sprains and more.

Physical Therapists and other health care providers use kinesiology tape to balance an over worked muscle or joint, decrease swelling in a joint, or create a low pressure are for fluid to move and drain. Kinesio tape has a variety of therapeutic benefits, including psychological, structural, circulatory and neurosensory.

Valerie Gregory, Physical Therapist at Affiliated Foot and Ankle Center, LLP in Howell, NJ received her Kinesio Taping Certification in 2009.

By Valerie Gregory, MSPT, CKTP

Tags: Affiliated Foot and Ankle Center, Ankle Sprains, foot injuries, foot pain, heel pain, howell, kinesio taping, plantar fasciitis, valerie gregory
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Can Botox Really Stop Sweaty Feet?

Monday, March 7th, 2011

Sweaty feet. For most of us this is only a problem after a hot, summer day or after exercising. But what if your feet are sweaty all the time? What if your sweaty feet are such a problem that it changes the way you live your life?

Hyperhidrosis is a medical condition in which a person sweats noticeably more than the average person. These people have overactive sweat glands and sweat even in cool temperatures and when they are at rest. Excessive sweaty feet can be embarrassing. Some people with hyperhidrosis are forced to change their socks several times a day, are fearful about smelly feet, and refuse to wear sandals and open-toe shoes. Sweaty feet can also cause health problems. Excess moisture on feet can lead to the growth of different types of fungi.

Recently, people with hyperhidrosis have found success in using Botox to treat excessive sweating. Yes, Botox, the same thing celebrities have been using for years to maintain a youthful face. Botox has been approved by the government to treat sweaty underarms and now it is being used to treat sweaty feet! Botox is a toxin produced by bacteria and when it is injected into the feet, it paralyzes the sweat glands. The result is a major decrease in the amount of sweat the patient’s feet produce. These results can last for 6 to 15 months. Using Botox to treat your sweaty feet may seem like the perfect answer, but before you withdraw bank funds, go see your podiatrist!

At the Affiliated Foot & Ankle Center, LLP, we can answer questions about sweaty feet and any other foot issues you may have. We have locations at Howell, Edison, and Monroe, New Jersey. By contacting a podiatrist you can learn more about hyperhidrosis and different ways to treat the condition. Botox may not be for everyone. Treatments can range from $1200 to $1800 for both feet and the procedure requires 25 to 35 needle injections. A podiatrist can discuss less costly treatments such as using foot powder, wearing socks that absorb moisture better, and even changing your diet (Caffeinated drinks, alcohol, and some hot spices can cause excessive sweating).

Let’s face it. There are over 250,000 sweat glands in the foot and at some point we all will experience sweaty feet! However, if you think your feet sweat more than normal, it is okay to learn more about hyperhidrosis and to tell your podiatrist about your concerns. Who knows, you too may find success with Botox.

By: Dr. Varun (Ben) Gujral

Tags: Affiliated Foot and Ankle Center, botox in feet, Dr. Varun (Ben) Gujral, excessive sweating, feet smell, foot doctor, foot fungus, for sweaty feet, fungi, Hyperdrosis, podiatrist, podiatry, smelly feet, Sweaty Feet
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What Do Your Feet and Your Butt Have In Common?

Monday, January 24th, 2011

Shoes change with the season and with trends. They may change with age and various styles. Shoes are an important part of the fashion world and with daily lifestyle. Popular culture megastar Lady Gaga makes statements with the bizarre shoe styles she wears and can become a symbol that is associated with her and become so significant that they are very recognizable. Everyone knows Dorothy’s ruby red slippers or Cinderella’s glass slipper as well. Certain eras throughout America went through extreme shoe style changes. The Fifties had Saddle shoes. The sixties were barefoot, to stilettos, to high heel boots. The seventies had platform shoes and earth shoes. The eighties changed to sneakers and colorful pumps and the nineties Doc Martins and return of the platform shoes. As with every other era today there are a variety of shoes that symbolize the current.

Toning shoes, Uggs and converse are all popular styles today that may not all give the most support for proper foot function. At Affiliated Foot & Ankle Center, LLP, in Howell, NJ where I practice, all of the following are popular styles that I receive questions on regularly. Toning shoes are a very big trend for companies such as New Balance and Sketchers. They make claims that one who wears and walks in the shoes will burn more calories and tone the back of the legs and butt. There are several different models of these shoes and some work better than others. Do not be fooled by any of the claims they make. Recently there has been a class action lawsuit brought against New Balance for false claims. The shoes are a new trend and do help patients with back pain and some foot pain but may not provide the muscle toning capabilities that they claim. The American Podiatric Medical Association has listed the toning shoes that they recommend. If anyone is interested in these shoes for comfort or style they should get the shoes that the AAPMA endorses.

If you think you foot pain, have any questions about shoes, or would like more information about Affiliated Foot & Ankle Center, LLP, with locations in Howell, NJ, Edison, NJ and Monroe Township, NJ, please visit www.footdoctorsnj.com.

By: Dr. Alison DeWaters

Tags: foot pain, Lady Gaga, proper footwear, shoes
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Happy New Year to your feet!!!!

Thursday, January 13th, 2011

In this new year of 2011 many people have made resolutions and have made weight loss a priority. I know my wife is working out everyday to get ready for our cruise. Just to let you know, I have been married for 10 years and this is a long awaited trip without our children. I love my children but sometimes, mothers and wives need a break!!!! Sorry that I digressed!!!!

One of the things that occur while people engage in weight loss plans is “working out.” When people work out whether at home or at the gym, they will start without a real plan. I mean most people will jump up and pop in a DVD and start doing Zumba or cardio exercises. One thing that can occur while working out is pain in your feet. And if you follow our blogs, we at Affiliated Foot & Ankle Center, LLP, with offices in Howell, NJ, Edison, NJ, and Monroe Township, NJ always state the foot pain is not normal. So, here is my not normal list:

Heel Pain-
1. Injury to the heel that will not get better after a period of rest- this can be a contusion (bruising) or a stress fracture.
2. Arch pain, which gets better after a period of rest (Heel pain syndrome).
Tendonitis
1. Arch Pain – this can a condition called Posterior Tibial Tendonitis- this should be addressed immediately…
2. Peroneal Tendonitis- pain on the outside part of the foot.
3. Achilles Tendonitis- pain in the back of the ankle.
Stress Fracture- can be severe and can occur in any part of the foot.
Athlete’s Foot: itchy and cause the feet to be painful and stinky even cheesy smelling…lol. Also, this is an infection and cause other problems such as nail fungus.
Toenail problems- dark spots in the toenails and this can be caused from ill fitting shoes. Blood can be under toenail which can cause pain and pressure. Also, constant injury to the toenail can contribute to fungus.
Shin splints- pain in your legs and this can cause you to stop working out and it can cause a feel of your legs feeling fatigued.
Pain- if you have bunion…you those big bumps on the side of the big toe joints…these can be painful. Hammertoes…..guys look at your girls’ feet…those curled up toes….these can be painful and ugly. HAMMERTIME!!!!!
Numbness….Do you have Diabetes, Vitamin deficiencies, or even Tarsal Tunnel (compression of a big nerve on the inside part of the ankle)?….Not normal…Alcoholism can cause numbness…Maybe your resolution is to stop drinking.
Ankle Sprains….Painful, bruised ankles from Zumba or running ….Get it check…this can lead to frequent ankle sprains.
Flatfeet…these can cause arch pain, bunions, hammertoes and numbness..Some people feel that they have no support…..

These are just some conditions that can occur while working out…Obviously this is not a complete list….But this is to give you an idea of some common ailments. So, while you are trying to stay true to your resolution…Remember foot pain is not normal and if you are experiencing it please call our TEAM at Affiliated Foot & Ankle Center, LLP in Howell, NJ at (732)-905-1110. And if you are in the Edison, NJ area or the Monroe Township, NJ area please call (732)-662-3050!!!!!

By: Dr. Jasen Langley

Tags: 2011, achilles tendonitis, arch pain, Athlete's foot, bunion, cruise, Dr. Jasen Langley, Exercise, flatfeet, hammertoes, heel pain, numbness, pain in your feet, peroneal tendonitis, shin splints, stress fracture, toenail problems, working out, Zumba
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Cold Weather Exercising? YES!!!

Tuesday, January 4th, 2011

Winter running or biking outdoors is tough on your body temperature. It is best to dress in layers when exercising outdoors below 40 degrees Fahrenheit. One of the hardest things about exercising outside in the cold weather is dealing with cold feet. I battle that problem every winter. My running shoes are not the best for outdoor runs or bike rides. The wind goes right through my Asics Kayano’s and my feet go numb after 20 minutes.

So what is the solution? (Follow these helpful hints to keep your feet warm during cold weather exercise)

Wear running shoes with little mesh as possible. Most running shoes are made with a mesh fabric which allows moisture to evaporate, best for warm weather. Trail running shoes are the best for the cold and wet days. Most trail running shoes are somewhat water-proof and will give you a little more traction in the snow.

Be sure to wear a good pair of wicking socks made of fabrics such as acrylic, CoolMax, or wool. Never wear cotton socks, this applies to cold or warm weather, when running because they won’t wick away the moisture, leaving your feet wet and at risk for frostbite. If it’s really cold, you may need to wear two pairs of socks; one thinner (synthetic material) pair closest to your feet and a thicker (wool) pair over them. For this strategy, you have to be careful that your running shoes still fit properly with the extra layer. You may want to purchase another pair of running shoes that are a 1/2 size bigger than regular running shoes, so you have some extra room. To help prevent your feet from sweating too much, spray anti-perspirant on them before you put your socks on.

Your feet will obviously be the coldest at the beginning part of your run/bike ride. To avoid that uncomfortable feeling for your first mile or so, try marching or slowly jogging in place for a few minutes inside before you head out.

Some exercise enthusiasts love to put in hand warmers in their running shoes. I especially use them in my ski boots when I hit the mountains. They’re easy to use: Just take them out of the package and put them inside your sock, on top of your toes. Once your feet warm up, you can take them out so you don’t overheat.

Try to avoid puddles, slush, and snow. This may sound like common sense, but steer clear of wet ground. It may seem like fun to run in the snow for a little while, but your feet will get wet and cold quickly.

Wear a hat. This may sound strange as a cold feet prevention tip, but you can lose a reported 40% of your heat from your head. So, in order to help keep the rest of your body warm, you need to make sure your head is covered. Wear a wool or synthetic-blend hat that will wick away sweat.

Enjoy the outdoors and don’t be a couch potato!

By Valerie Gregory, MSPT, CKTP

Tags: Add new tag, athlete, athletes, Exercising, foot pain, Frostbite, howell, proper footwear, runner, runners, valerie gregory
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My Interesting Trip Back to Jersey; Thoughts About the Dangers of Frostbite

Thursday, December 30th, 2010

Tis the holiday season… Thanksgiving, Chanukah, Christmas, New Year’s Eve and all the usual activities that goes along with it… except for the freakish blizzard that pummeled the Northeast over this past weekend.

I recently drove home to Ohio from New Jersey to spend some quality time with my new wife and her family. Near the end of my mini vacation, I packed up my car and heard about the bad snowstorm. I left for New Jersey on Monday, Dec 27^th. The 500 mile trip along the toll roads was great, a little snow and lots of wind, but that was all. It wasn’t until I was within 25 miles of Howell, NJ when I got off the turnpike that I realized how bad the snow was; it was easily 2 ½ to 3 feet.

As I was driving cautiously through the blizzard, I kept thinking about a patient I had encountered a while ago in Iowa. The snow out there was terrible, and with the wind chill, it was 35 degrees below zero. The patient had been shoveling snow outside wearing his work boots for several hours. After he was done, he went inside to relax.

We saw him in our hospital about one month later. When he came in, his right big toe was all black and necrotic (dead tissue). When we asked him what had happened, he told us and that he thought his toe would get better on it’s own… it didn’t.

For the sake of this blog, I will not get into the different types of frostbite, rather I will focus on what you can do to avoid getting it in the first place.

Frostbite Prevention 101:

1. Predisposing factors:

a. Minimize your exposure to the environment

b. Know what the wind chill factor is

c. Wetness – keep your feet dry; change your socks frequently

2. Individual factors

a. Age – the older we get, the less time we should be outside

b. Nutritional status – are you well nourished? Do you have the energy storage necessary?

c. Physical and mental condition – do you exercise regularly? Cardio training?

d. Alcohol and smoking habits –

i. Alcohol might make you feel warm, but it takes away body heat

ii. Smoking constricts blood vessels, making it harder for blood flow

If you have been outside for a long duration of time; skiing, snowboarding, walking, or shoveling the driveway, you might be at risk of getting frostbite. Some warning signs to look out for:

1. Extremity may feel hard, appear pale or purplish

2. If you squeeze your toes with your fingers, it may take longer for the color to return than usual (we call this capillary refill time – you can try this by squeezing your thumb for a few seconds, letting go and count how long it takes for your thumb to return to normal color)

3. Within 24 hours, blisters will develop, swelling occurs, and more reddish-purple discoloration appears

4. After several days, the blisters enlarge and become blood blisters

The list is more extensive than this, but if you suspect that you might have frostbite, it is a medical emergency for you to see your doctor right away (within 24 hours). If it is frostbite and depending on how soon you are seen for it determines the course of treatment. The course of treatment is ONLY to be performed under the direct supervision of a physician! You can do more harm than good by treating it yourself.

Don’t forget, if you suspect you might have frostbite and you live around the Howell, NJ area, feel free to call our TEAM at Affiliated Foot & Ankle Center at (732) 905-1110. If you are located around the Edison, NJ or Monroe, NJ areas, please call our office at (732) 662-3050. In the meantime, stay warm, stay safe and have a very Happy New Year!

By David Hunnicutt

Tags: edison, feet pain, foot, foot injuries, foot injury, foot pain, Frostbite, howell, monroe, redness
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Keep Your Feet Warm!!!

Tuesday, December 14th, 2010

As we now enter the cold winter weather, many of us will be skiing, sledding and shoveling snow. Many people will get cold feet as well as wet feet; no matter if our boots are waterproof, we have to protect ourselves from frostbite.

Frostbite is a thermal injury caused by cold weather. It can affect distal extremities such as fingers and toes. This condition can be very painful; also, it can cause a loss of these extremities.

Frostbite can be caused at vary degrees below freezing. Past medical history, tobacco use and ethnicity can play an important role in the condition. Peripheral vascular disease, diabetes, and sickle cell anemia are some medical conditions that impair circulation which is critical in bringing warm blood, oxygen and nutrients to the extremities.

Wet clothing can lower the temperature which can cause parts of the body to become very cold. When this occurs, the toes become very red and painful. If the frostbite progresses, the skin can blister and if the freezing in the skin deepens the blister can fill with blood and potentially lead to skin death or necrosis. Joints can become very stiff and the skin and extremities must be re-warmed as soon as possible.

Medical treatment for frostbite must be instituted immediately to promote warmth to the extremities or toes. Warming of the toes can be treated by placing them in warm to hot water for a period of time. If there are blisters, they must be debrided or drained and all non-viable or dead tissue should be removed. Silvadene, which is used for burns with anti-microbial properties, is usually used to treat and dress the wounds. The wounds should be monitored to determine if any surgical debridement is indicated. If the frostbite is severe, amputation may be indicated. Sometimes, antibiotics may be instituted to prevent any progressing infection.

As with any potentially limb threatening condition, prevention is the best treatment. If there is severe winter weather, you must be aware that if your shoes and socks are wet for a prolonged period of time, they should be change to dry warm ones. If you have any condition that can affect your circulation, you should check your feet often. If there is any redness in the toes, you should attempt to re-warm your toes and feet and if there are any blisters, you should seek immediate medical attention.

If it is snowing and you have red toes, please visit a podiatrist of come to Affiliated Foot and Ankle Center, LLP at one of their office locations in Howell, Edison and Monroe, NJ.

By Dr. Jasen Langley

Tags: Diabetes, Dr. Jasen Langley, feet pain, foot injuries, foot injury, foot pain, Frostbite, howell, peripheral vascular disease, redness, toe pain
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What is Turf Toe?

Monday, December 6th, 2010

Turf Toe is a sprain injury to the big toe joint (also known as the 1^st MPJ, hallux or great toe). The incidence of this injury has increased over the years secondary to athletic fields being covered by artificial turf and also by increased flexibility of the toe box in athletic shoes.

The rough nature of many contact sports is a factor involving abnormal extension, flexion and rotational movements that cause injury to joints and soft tissue structures. One such injury is a sprain to the big toe joint, commonly referred to as turf toe. Turf toe is seen most common in football, but it can occur in any activity, such as soccer, tennis, volleyball, wrestling and even dancing.

The big toe joint is composed of 4 bones, 9 ligaments, 3 muscular attachments and the joint capsule (which is considered a ligament). Two of the bones are called sesmoids, which are encapsulated inside a tendon and the other are two are 1^st metatarsal bone and the proximal phalanx (your toe, which moves up and down). Your big toe joint has a large range of motion in two main directions: dorsiflexion (toe going up) and plantarflexion (toe going down). This is required for normal ambulation, however when this range of motion is exceeded, you get turf toe.

The most common example of turf toe is in a football player. If you can imagine a football player at the start of a play, you will notice that the athlete has their foot planted on the ground, the big toe joint hyperdorsiflexes (bending more than it should) and the heel is raised up off the ground. During an applied downward force (up to 8 times his/her body weight), the big toe is dorsiflexed beyond its biomechanical limits, resulting in tear of the joint capsule.

The initial treatment of turf toe is RICE: rest, ice, compression and elevation. In the initial stages of suspected turf toe, taping is not recommended due to the swelling that occurs and the possibility of neurovascular compromise. Is you suspect that you may have a turf toe injury, call your podiatrist and have them take x-rays to rule out a possible fracture. If you happen to live close to Howell, New Jersey, call “Affiliated Foot and Ankle Center” to make an appointment at (732) 905-1110. Our friendly podiatrists will get you back on your feet!!!