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Kevin F Gallagher, DPM
Board Certified in Foot and Ankle Surgery
(724) 941-4330


June 2024

The purpose of the body’s circulation system is to transport blood, oxygen, and nutrients throughout the body. A reduction of blood to a specific part of the body may cause one to experience symptoms of poor circulation. The most common causes of poor circulation in the feet are obesity, diabetes, and heart conditions such as peripheral artery disease (PAD). Common symptoms of poor circulation include tingling, numbness, throbbing, pain and muscle cramps.

Peripheral artery disease is a common cause of poor circulation in the legs. Symptoms of PAD are cramping, pain or tiredness in the leg or hip muscles while walking or climbing stairs. This pain tends to go away with rest and starts back up when you begin to walk.  It is a condition that causes the blood vessels and arteries to become narrow. Although PAD is more common in adults over the age of 50, it may also occur in younger people.  A similar condition called atherosclerosis causes arteries to stiffen up due to a buildup of plaque in the arteries and blood vessels.

Blood clots are also a common cause of poor circulation in the feet. Clots may obstruct blood vessels and if they occur in the legs, they may eventually lead to pain and discoloration. This occurrence is commonly known as deep vein thrombosis (DVT) and it may travel to the lungs. Varicose veins are another condition that may lead to poor circulation, and it is caused by incompetence of the valves in the veins. Women who are overweight are prone to developing this condition. Lastly, diabetes, which is correlated with poor blood sugar metabolism may lead to chronic poor circulation. Those with diabetes often suffer from cramping in the legs, calves, thighs and buttocks.

If you are looking for ways to avoid poor circulation there are some tips you can follow. One tip is to avoid sitting for too long. If you plan to sit down for a long period of time, you should try standing up occasionally, to improve your circulation. Another great way to avoid poor circulation is to exercise. Exercise is an excellent way to pump the heart and increase blood flow. Those who suffer from poor circulation should also avoid smoking, reduce their salt intake, and try to lose weight.

If you are experiencing symptoms from poor circulation in your feet, you should consult with your podiatrist to determine the best method for treatment for you. He or she may prescribe medication in addition to recommending specific lifestyle changes to improve your circulation.

The ankle is a hinged synovial joint made up of three bones: the tibia (shin bone), the fibula (outer ankle bone), and the talus (between the heel and leg). These three bones are bound, supported, and stabilized by strong, fibrous bands of tissue called ligaments.

A break in an ankle bone can be either traumatic or stress related. This injury may be referred to as a break or fracture. A traumatic fracture can result from tripping, twisting or rolling the ankle, falling, or by blunt impact to the ankle. These traumatic ankle breaks usually occur during sporting activities or accidents. Stress fractures, however, occur over time and are the result of repetitive stress to the ankle. These fractures sometimes occur when a new activity that engages the ankle is introduced, or when the level of activity is abruptly increased or intensified. 

There are various symptoms that accompany an ankle break. The most significant symptoms are pain and swelling that occurs in the ankle and sometimes spreads up from the foot to below the knee. Bruising or discoloration may develop eventually. It will be difficult or even impossible to put weight on the affected foot, and in severe cases there may be a visible deformity or even exposed bone.

It is very important to seek immediate treatment when an ankle break occurs or is suspected to have occurred, in order to allow the bone to properly heal and to avoid future complications such as stiff joints, limited range of motion, and osteoarthritis.

To diagnose a broken ankle, your podiatrist will first ask you to explain how the injury occurred and what your symptoms are. They will perform a thorough examination, checking for damage to nerves, blood vessels, and other structures around the injury site. They will also test your range of motion. An X-ray will need to be reviewed and, in some cases, an MRI or CT scan may be necessary.

Proper treatment of a broken ankle will depend on where and how severe the break is, how stable the ankle is, and whether the bone is displaced (misaligned or separated) or non-displaced (broken yet still aligned properly). 

Mild fractures (where the bone is non-displaced) may be treated by resting, icing, and elevating the ankle at first, followed by immobilization with a cast or walking boot. Pain and inflammation may be treated with acetaminophen. More severe or complicated fractures where bones or joints are displaced may require surgery. 

Recovery time will also vary, and it may take 4-6 weeks or longer for a broken ankle to heal. Your podiatrist will most likely order progressive X-rays or stress tests to be taken in order to monitor the healing process.

Tuesday, 11 June 2024 00:00

Falls Prevention

Elderly Americans are very susceptible to falls as they get older. Everyone experiences decreases in flexibility, balance, strength, and the senses as they age. This correlates to some eye-opening statistics. 1 in 4 Americans aged 65 and older fall each year. An elderly American is being treated for a fall in an emergency room every 11 seconds, and every 19 minutes, an older person dies from falling. In light of these striking statistics, one can see the importance of taking steps to prevent falls.

Finding an exercise program for the elderly is an excellent way to reduce the likelihood of falls. Look for an exercise program that improves strength and balance. Elderly people who live a more sedentary lifestyle, with little physical activity, are at an increased risk of falling. Wearing well-fitted footwear that provides good foot support and cushion will help prevent falls from poorly fitted shoes. Talking to a podiatrist about your susceptibility to falls and about inspecting your prescriptions will help to avoid any medication that could make falls more likely. Due to a decline in the senses among the elderly, having your eyes and hearing checked is recommended.

Around half of all falls occur in the household. Removing tripping hazards in the home and making it more accommodating to older persons can significantly reduce falls. Some notable household changes include increasing lighting around the house, installing grab bars in the shower and bathroom, and making sure the floor is clear of clutter. Other smart options include installing a shower chair, using rubber-bottomed rugs, and placing railings on both sides of stairwells.  

Finally, discuss with a doctor and your family about your fear of falling. This will help to increase awareness among the population on the need for fall prevention. A lack of awareness on the matter, and a downplaying of importance are what increase the risks of falling. Following these tips can help to reduce the risk for yourself and your loved ones.

 

Tuesday, 04 June 2024 00:00

Diabetic Foot Conditions

According to the American Diabetes Association (ADA), diabetes is a condition that affects approximately 23.6 million Americans.  Around 750,000 new cases are diagnosed each year, and the disease’s most common form, Type 2 diabetes, makes up for 90 to 95 percent of these cases.  Type 2 diabetes is especially prevalent among older Americans, those who are obese, and those who lead sedentary lifestyles.

Complications of the disease may lead to several foot and ankle-related conditions.  The loss of nerve sensation, or neuropathy, can cause diabetics to lose feeling at the bottom of the feet and therefore leave them unaware of pain, pressure, and heat.  Decreased circulation is another complication of diabetes that can slow down the healing of wounds and injuries; this can lead to the development of foot ulcers.

To prevent foot ulcers from forming, diabetics should examine their feet every day for small cuts and wear shoes that curtail pressure.  Constant monitoring for the risk factors associated with ulcer formation can allow for early detection and therefore lessen the possibility of ulcers or, even worse, amputation.  The removal of calluses and ingrown toenails should be left to the podiatrist to avoid improper removal and possible infection.

Diabetic patients may also experience foot deformities due to complications in their feet, such as limited joint mobility, muscle atrophy, and decreased fat padding.  These complications can increase pressure in certain areas of the foot, which in turn can cause certain deformities, such as hammertoe, to form.  Another deformity, Charcot foot, develops due to the collapsing of microfractures in the bones of the feet.  The resulting deformity is a foot that is flattened and wider in appearance.

To help minimize pressure and prevent the development of these diabetes-related foot and ankle conditions, your podiatrist may consider using orthotics or special shoes.  Charcot foot may be treated using walkers, custom orthotic insoles, or non-weight-bearing or rigid weight-bearing casts or braces.  In more serious cases, surgery may be considered to treat more developed deformities.  Ulcers can be further cared for with the help of proper diet, medication to control glucose, intensive wound care, and infection treatment.

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