Bridge Run Tip: Don't wait to get New Shoes

With the Cooper River Bridge Run only a month away, please don't wait until only a couple days before to replace your running or walking shoes...even if you plan on replacing them with the same exact pair, give it a couple of weeks to break them in properly. Just because they look the same doesn't mean they will feel the same and you may end up with blisters and more.

We are looking forward to the run and hope to see you there!

Cooper River Bridge Run Injury To Watch for: Black Toenails

If you're still training for the Cooper River Bridge Run, give yourself a pat on the back! The treacherous Charleston weather has made it difficult for many to keep to their training routine. One injury to watch for as you up your mileage is black toe also known as black toenails. Black or darkened toenails are essentially bruised nails and can result from a variety injuries or problems. Darkened nails may occur as a result of the toe hitting the end or the top of the shoe toe area. Meaning your shoes may be too small for you as well. Sometimes, the bruise can lead to a fungal nail infection.

Keep an eye on your nail and call us for an appointment. Dr. Brown has seen plenty of these in his day, so don't worry, he can help!

www.carolinafootspecialists.net 

Keeping Your Toes Pretty for Spring

Let's face it, spring and summer in Charleston means it's time to bring out the flip flops and open toed sandals. Many of our patients enjoy getting pedicures once this time of year comes around, but we have to be sure they stay safe when getting pedicures. If they've been wearing nail polish all winter long and remove it, they may notice a yellowing of the toenail. This may be a fungus as the nail polish hasn't given the nail any opportunity to breathe. To keep your toenails looking clear and fungus free. We offer a simple treatment called Clear Nails-pro. This is the liquid form of the oral Lamisil that is taken by mouth. Clear nails is a topical antifungal treatment which consists of Ciclopirox, Lamisil, and fluconazole. This option for treatment of fungal infected toenails is safe, minimal cost, and easy to apply.

Some other pedicure pointers from our friends at the APMA include:

Schedule your pedicure first thing in the morning. Salon foot baths are typically cleanest earlier in the day. If you're not a morning person, make sure that the salon filters and cleans the foot bath between clients.

Bring your own pedicure utensils to the salon. Bacteria and fungus can move easily from one person to the next if the salon doesn't use proper sterilization techniques.

When eliminating thick, dead skin build-up, also known as calluses, on the heel, ball and sides of the feet, use a pumice stone, foot file or exfoliating scrub. Soak feet in warm water for at least five minutes, then use the stone, scrub, or foot file to gently smooth calluses and other rough patches.

When trimming nails, use a toenail clipper with a straight edge to ensure your toenail is cut straight across. Other tools like manicure scissors or fingernail clippers increase the risk of ingrown toenails because of their small, curved shape. See a podiatrist if you have a tendency to develop ingrown toenails.

Have questions? Call us at Carolina Foot Specialists
Charleston Office
843-225-5575
Mount Pleasant Office
843-654-8250

State of the art technique for treating plantar fasciosis "Topaz."

The most common diagnosis that we see in our practice is heel pain most commonly plantar fasciitis. In the chronic form we refer this as "Plantar Fasciosis." Plantar fasciosis can be unresponsive to conservative treatment such as NSAIDS, cortisone injections, custom orthotics, PT, tapings, shoe gear changes, and night splints.
WHEN HEEL PAIN REACHES THIS RECALCITRANT STATE TREATMENT MUST BE REFOCUSED FROM DECREASING INFLAMMATION TO STIMULATING IT.

In years past chronic heel pain was treated with releasing the plantar fascia. Dr. Brown and Dr. Saffer are trained on utilizing lesser invasive techniques to keep the anatomy intact and get you back on your feet faster.

The minimally invasive technique that Dr. Brown and Dr. Saffer use is called Topaz for chronic plantar fasciosis. This procedure uses a small Coblation wand into the plantar fascia through multiple pin size areas of the heel. The procedure focus is on increasing vascularity (blood supply) and cell proliferation to promote healing of the plantar fascia. The procedure takes 20 minutes under IV sedation/local anesthesia. This procedure involves no sutures and weight bearing can be tolerated the day of the procedure. We typically place patient in a walking boot for one week then progress into a sneaker.

Dr. Brown and Dr. Saffer use this surgical technique only after all conservative treatment has been exhausted. Minimal to no complications are involved with this procedure because it is so minimally invasive. We typically see about 70-80% resolution/decreasing symptoms in our patients. The procedure is covered by insurance and affords patients minimal down time with work.

To view this procedure please refer to the link below from one of our Podiatric colleagues in Chicago.

http://www.youtube.com/watch?v=Ca4lYQUr6jI

State of the Art healing options for Chronic Plantar Fasciosis

We at Carolina Foot Specialists are keeping up with the latest techniques for conservative and surgical treatment for chronic heel pain (Plantar Fasciosis).
Our Doctors over the next few months will be attending foot and ankle conferences in Utah, Orlando, and Atlanta to become educated and trained in some of the latest techniques for treatment of chronic recalcitrant heel pain as well as other foot and ankle disorders.
Heel pain is the most common foot complaint that we see in our offices. Dr. Brown and Dr. Saffer both have the same philosophy with regards to an aggressive conservative treatment plan for acute and chronic heel pain. They both come up with a treatment plan that still allows each patient to be active while undergoing treatment.
We are going to explore over the next few weeks minimally invasive surgical options for chronic heel pain more specifically "Topaz." Dr. Brown and Dr. Saffer both utilize the Topaz technique which is a quick outpatient procedure that allows the patient to go back into running shoes within two to three days after the procedure. No sutures are needed with this procedure and the recovery time is fast.
Our next blog we will discuss Topaz in more detail as well as in future blogs discuss a newer technique called "PRP."

Is heel pain always plantar fasciitis?

It is very important to understand that if you are experiencing heel pain it may not be plantar fasciitis. You may go to your local shoe store and while trying on shoes you may complain of heel pain. If you are told that it is plantar fasciitis this may be an incorrect assumption. We strongly recommend if you are experiencing any type of foot pain for a period of longer than a week than you should be evaluated by our professionals. It is not normal to have foot pain for this period of time and having a correct diagnosis is key to a quick recovery.

It is true that if you have heel pain it is more than likely plantar fasciitis in the acute setting. The problem is if not evaluated properly you could be getting the wrong advice and this may prolong your recovery.

Heel pain can present as different foot conditions such as a heel fracture, bone tumor, nerve injury, arthritic condition, or in a chronic form "Plantar Fasciosis." Imagine you were told by a friend that you have plantar fasciitis and actually had a stress fracture of the heel. You could of been evaluated initially with a digital x-ray at one of our offices and immobilized with a cam walker boot to allow the fracture to heal. Instead you treated yourself for plantar fasciitis and wondered why you were not getting better.

Our practice both at the West Ashley and Mt. Pleasant offices have state of the art diagnostic equipment. We have digital x-ray (20/20 imaging) which allows us to have a crisp, clear, image of the foot in minutes. We also have state of the art diagnostic ultrasound which allows us in the office to look inside your foot and see soft tissue inflammation and more specific anatomy of the foot. Diagnostic Ultrasound allows us to inject if needed cortisone into the fascia to accelerate healing. We have techniques which are virtually painless for our patients.

We know what is like to experience heel pain and other foot ailments. We both are avid runners and understand that our patients want to get back to being active. We believe that it is imperative that each of our patients with heel pain or other foot conditions is first properly diagnosed. We then at Carolina Foot Specialists come up with an aggressive conservative treatment plan to resolve heel and foot pain as quickly as possible. 

We will in future blogs explore Plantar Fasciosis/Plantar fasciitis in more detail and discuss our state of the art conservative and surgical options.

Redefining Plantar Fasciitis

   In our practice heel pain is one of the most common diagnosis that we see in our practice. Over the next few months we would like to discuss a condition called "Plantar Fasciosis." This is typically a chronic form of heel pain that has been present for more than two to three months and unresponsive to conservative treatment. Perhaps one of the most pivotal points to address is the fact that what we commonly call plantar fasciitis is not inflammatory but is actually a well documented degenerative condition (Plantar Fasciosis).

In his landmark 2003 study, Lemont demonstrated that there were no histological mediators of inflammation within 50 specimens sent by surgeons for pathological examination from their surgical cases treating plantar fasciitis. He correctly points out that we should really call this condition “plantar fasciosis” because of its degenerative nature without the presence of inflammation.

In our future blogs we will discuss plantar fasciosis in more detail and discuss treatment options to help accelerate healing of this chronically degenerative condition of the plantar fascia.