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Posts for: June, 2015

By drjenniferz@clevelandfootdoctors.com
June 15, 2015
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Cuboid syndrome, also called cuboid subluxation, is a common type of foot injury, particularly in athletes. Even though it is common, it is often misdiagnosed and subsequently treated improperly.

Cuboid syndrome occurs when there is an injury or dislocation on the lateral side of the foot, the outer side with the small toe. The injury is in the area of a small tarsal bone in the foot, the cuboid bone. The cuboid bone is located roughly at the midpoint of the outer side of the foot, and together with the other tarsal bones, it forms the arch of the foot. Other structures that may be involved in the injury include the calcaneocuboid joint and the surrounding ligaments.

cuboid syndromeWhat Causes Cuboid Syndrome?

Typically it is athletes who develop cuboid syndrome, either after an injury, or as lateral foot pain that appears without a noticeable injury. Athletes presenting with cuboid syndrome are often runners or ballet dancers, and one study showed that as many as 80 percent of cuboid syndrome patients also have flat feet.

Cuboid syndrome is often associated with repetitive movement of the foot, such that which occurs during running or dancing. The muscle that is believed to be associated with cuboid syndrome is the peroneus longus muscle, a muscle located on the outside of the lower leg and is responsible for stabilizing the midfoot. Continual or repetitive movement of this muscle may result in a malalignment of the cuboid bone.

Another possible cause of cuboid syndrome is an injury, such as a sprained ankle. An ankle sprain in which the foot turns inward (called an inversion ankle sprain) may damage the ligaments connected to the cuboid bone. This type of ankle injury can happen to almost any athlete, but is common with basketball, football, and soccer players.

Signs and Symptoms of Cuboid Syndrome

- Pain, particularly in the lateral midfoot, especially when walking.

- Redness and/or swelling.

 -  If the cuboid syndrome is associated with an ankle injury, there may also be pain, swelling, redness, and restricted movement in the    ankle.

Diagnosing Cuboid Syndrome

During a physical exam, the following findings point to a diagnosis of cuboid syndrome:

Pain: The lateral midfoot is tender, and palpating the area may be painful. There may also be redness in the area (erythema) and slight swelling. Patients may also experience pain when hopping on the affected foot, or may even be unable to hop.

Decrease in motion: Patients with cuboid syndrome may find inversion ankle movement to be painful, and may resist or avoid these movements.

Uneven gait: Patients with cuboid syndrome may exhibit an antalgic gait — i.e., they seek to avoid putting weight on the affected foot. Pain during walking may occur as the foot pushes off the floor.

There is no one specific test that can be conducted to accurately diagnose cuboid syndrome, but there are maneuvers that may aid in diagnosis.

Midtarsal adduction test: While stabilizing the ankle joint with the right hand, the left hand is used to hold the foot around the midpoint. The foot is then moved inward, in the direction of the other foot. This movement compresses the patient’s calcaneocuboid joint and may cause the symptoms of cuboid syndrome.

Midtarsal supination test: In this test, the ankle joint are again stabilized while the foot is manipulated in roughly a half-circle (this is also called triplane motion). This motion will also cause the pain of cuboid syndrome.

Treatment of Cuboid Syndrome

Treatment of cuboid syndrome involves manipulation of the cuboid. In cases in which cuboid syndrome was secondary to an ankle injury, treatment may be postponed until the ankle has healed sufficiently. If there is redness, swelling, or a hematoma present on the foot, those conditions should be adequately resolved before manipulation of the cuboid is attempted.

After manipulating the cuboid bone, further management of  the patient consists of massage, cryotherapy (ice), non-thermal ultrasound and/or electrical stimulation. In some cases, manipulation may need to repeated.

Further Treatment and Prevention for Cuboid Syndrome

Other treatments may be used to prevent the injury from recurring or to provide relief from any lingering symptoms after manipulation.

Padding and taping: Supporting the cuboid bone with padding or a wedge may help prevent recurrence. Taping may also be used to support and stabilize the bones of the midfoot.

Exercise: Exercises that can help with symptoms and prevent the injury from occurring again.

Orthotics: Because many people who develop cuboid syndrome also overpronate, orthotics may be useful in preventing recurrence. Orthotics are worn inside the shoe to promote the proper alignment of the foot.

If you or someone you know is experiencing this condition please given one of our offices a call for a consultation.  We are here to help!


By drjenniferz@clevelandfootdoctors.com
June 15, 2015
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It’s finally May, and we’re all spending more time outside and enjoying the warmth and the sun after another long, brutal Ohio winter.  However, May is also Skin Cancer Awareness month, and we need to remember that our skin pays the price for the enjoyment we get from blue, cloudless skies.  And while sun worshippers are familiar with the dangers associated with UV damage on their face, chest, and back, it’s important to remember that skin cancer is particularly dangerous on your feet.  Oftentimes, melanoma goes unnoticed by individuals with the telltale mole located on the sole of their foot- a surprisingly common place for skin cancer to appear.  So, the next time you throw those sandals on, take a moment to apply sunscreen to and examine your feet.

People are generally aware of checking other parts of their body for suspicious moles but they're unlikely to examine their feet. We advise patients to check their feet daily for any changes.  Even if you have limited mobility and can’t easily see the sole of your foot, you can place a mirror on the floor and check your foot for moles, lesions, cuts, or anything else that requires medical attention.  Please focus on the three most common areas for foot melanoma: the soles, between the toes, and around or under the toenails. 

Melanoma can develop anywhere on the body including areas that receive little sun exposure, such as the feet and ankles. If a mole, freckle or spot starts to change over the course of a month and becomes asymmetrical or changes its border, color, diameter or elevation, see a doctor immediately. Those are the ABCDEs, or signs, of melanoma.

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By drjenniferz@clevelandfootdoctors.com
June 15, 2015
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Have you ever woken up and immediately felt piercing, burning pain at the bottom of your foot? If so, it’s possible you could be suffering from plantar fasciitis. Plantar fasciitis is a form of heel pain caused by inflammation of the plantar fascia, which is the band of tissue that runs along the sole of your foot and connects your heel to your toes. In most cases, plantar fasciitis kicks in first thing in the morning or after waking from a nap, and gradually becomes more painful as time goes by.

Do you suspect you might be suffering from plantar fasciitis? Here are five things you need to know about plantar fasciitis and treatment.

1. How is plantar fasciitis caused?

Most cases of Plantar Fasciitis are caused by aging, weight gain or excess weight, wearing the wrong type of shoes, and exercising more frequently or for longer intervals. Also, individuals who have high arches or flat, flexible feet are most commonly affected by plantar fasciitis, and 71 percent of all individuals who wear high heels on a regular basis also tend to suffer from plantar fasciitis. The heel condition can also be triggered by calcium deposits in the heel bone, which can put excess strain on the ligaments that stretch across the bottom of the foot.

2. What type of shoes can help prevent and treat plantar fasciitis?

Since plantar fasciitis is often caused by wearing poorly-fitting shoes, most patients report relief after wearing shoes that help stabilize their heels. If your heels hurt when wearing certain shoes, press down on the back of your shoe near the heel to verify that the shoe is firm enough to stabilize your heel. If not, buy heel cup inserts or buy a new pair of shoes that fit more comfortably. Approximately 14 percent of all plantar fasciitis patients report experiencing relief after swapping out their shoes.

3. What is the best treatment for plantar fasciitis?

If wearing new shoes doesn’t alleviate your heel pain, make an appointment at one of Our Offices as soon as possible. We can fully assess your heel pain to verify whether you’re experiencing plantar fasciitis or another foot problem, and prescribe the necessary course of treatment. Possible treatment options include custom orthotics, nonsteroidal medications and/or cortisone injections. In severe cases, surgery may be recommended.

4. What types of stretches can help relieve heel pain?

While stretching and exercise may not prevent sore heels and reverse plantar fasciitis, stretching can help ease and relieve aches and pains associated with the foot condition. Perform the following stretching exercise to relieve plantar fasciitis:

  • Cross your left leg over your right knee, and grab your toes with your left hand.

  • Press your left foot toward your left knee, and hold for approximately three seconds.

  • Release the stretch, and pull your left foot away from your knee.

  • Repeat this stretch five times on each leg.

5. When should I see a podiatrist?

If you start experiencing sudden severe heel pain out of the blue, make an appointment with one of Our Offices as soon as possible. This is especially important for athletes, since complete rupture of the plantar fascia can lead to major setbacks and recovery that could take several weeks. In some cases, patients may be required to wear a boot and use crutches until the plantar fascia is completed healed.

 


By drjenniferz@clevelandfootdoctors.com
June 15, 2015
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It is summer and as women we like to have nice nails as we wear sandals.  However, how do we know we are getting a sanitary pedicure?  Here are a few things to look for to check if you’re going to a sanitary nail salon.

  • Was your nail file brand new? Under no circumstances should you ever have the same nail file or buffer used on your feet that was used on a previous salon client. You should always request a new nail file for your pedicure. Sanitary salons may also give you that nail file to take home with you. This is a nice gift that can be used later on and a good sign that your feet were treated with fresh supplies.
  • Is the work area clean of clutter and dirt? If the area on your nail technician’s workstation is cluttered or dirty, you can bet that her tools are not clean. Clutter and dirt make prime areas for fungus, germs, and viruses to grow, putting your feet at risk.
  • How long did the footbath have to sterilize between you and the person before you? Footbaths are breeding grounds for germs, fungus, and bacteria. To sterilize your footbath, your salon should scrub down all sides of the footbath and run a sterilization cycle of at least 10 minutes.
  • What type of liquid are the tools sterilized in? Ask what type of liquid is being used to sterilize the tools treating your feet. Sanitary nail salons use anti-fungal and antibacterial products and/or autoclave their instruments.

Please make sure the next salon that performs your pedicure and/or manicure follows the guidelines provided above to keep your feet feeling and looking healthy for the summer!


By drjenniferz@clevelandfootdoctors.com
June 15, 2015
Category: Uncategorized
Tags: Untagged

It is summer and as women we like to have nice nails as we wear sandals.  However, how do we know we are getting a sanitary pedicure?  Here are a few things to look for to check if you’re going to a sanitary nail salon.

  • Was your nail file brand new? Under no circumstances should you ever have the same nail file or buffer used on your feet that was used on a previous salon client. You should always request a new nail file for your pedicure. Sanitary salons may also give you that nail file to take home with you. This is a nice gift that can be used later on and a good sign that your feet were treated with fresh supplies.
  • Is the work area clean of clutter and dirt? If the area on your nail technician’s workstation is cluttered or dirty, you can bet that her tools are not clean. Clutter and dirt make prime areas for fungus, germs, and viruses to grow, putting your feet at risk.
  • How long did the footbath have to sterilize between you and the person before you? Footbaths are breeding grounds for germs, fungus, and bacteria. To sterilize your footbath, your salon should scrub down all sides of the footbath and run a sterilization cycle of at least 10 minutes.
  • What type of liquid are the tools sterilized in? Ask what type of liquid is being used to sterilize the tools treating your feet. Sanitary nail salons use anti-fungal and antibacterial products and/or autoclave their instruments.

Please make sure the next salon that performs your pedicure and/or manicure follows the guidelines provided above to keep your feet feeling and looking healthy!

Photo compliments of http://blissfullydomestic.com/