Foot Disorders
Podiatrist Jon Sherman, pictured here with his young patient, treats people of all ages and is an expert "foot doctor."
Pediatric Foot Disorders
Should I be concerned about the way my small child walks?
Parents are concerned about the well-being and growth of their children. Often times the parent wore corrective shoes as a child or now has problems with their feet or ankles and wonders if their child will have the same fate.
Below is a list of common concerns, what is considered normal, and when to seek our help.
Flat Feet
This condition is often referred to as pronation. All people pronate to some degree, but excessive pronation can lead to problems such as bunions and heel pain in adults. A large part of this tendency to pronate is inherited from the parents. It is normal for children to be flat footed up until the age of 6 years because of how the baby is positioned in utero and the development of the feet and legs after birth. If your child is over 6 years old, has one foot that is positioned much differently than the other foot, complains of pain or night cramps, or if a family member has had problems due to flat feet, you should see your podiatrist.
Toe Walking
Toe walking can normally be found in early walkers. Children should, however, start to walk heel to toe after 6 months of walking. If toe walking persists, you should always see a podiatrist to rule out an underlying neurological or musculoskeletal condition.
Bow Legs
At birth, infants have a small degree of bowing in their legs because of their position in the womb. This condition is usually temporary and the child will outgrow the bow legs by age 2 years. If the child still has bowing past 3 years, you should see your podiatrist.
Knock Knee
Knock knee is also a part of normal development of a child's growth. This condition usually starts at about age 2 and reaches its maximum at about age 4 years. It tends to disappear at age 6 or 7 years. If this condition is accompanied by foot, ankle, or knee pain or excessive tripping, or one leg looks much different than the other, see your podiatrist.
In-Toeing
The tendency to be in-toed (pigeon toed), like many of the previous conditions discussed, is inherited from the parents. A mild degree of in-toeing is perfectly normal. In fact, many professional athletes in-toe. Many children will outgrow this tendency by age 7 or 8 years. Some in-toeing is due to the position of the foot bones at birth. If your child is born with his or her toes pointed in and the foot forms a "C" shape when viewed from the bottom, seeing your podiatrist earlier may make it easier to correct this condition. When your child is older, if they trip often or complain of foot or leg pain, see your podiatrist.
When these treatment options are no longer providing the comfort you need, consultation with your podiatric physician is advised to discuss surgical options.
Alternating high heels with lower ones enables your physique to adapt and benefit from the plus-points of all heel heights.
According to podiatrist Jon H. Sherman, totally flat shoes are not the ideal for overall health of the feet or legs: a small heel is better. "Low heels of half to three quarters of an inch are good for both the front and back of the foot," he says.
"Small heels not only help reduce tension in tendons and ligaments around the foot, they also help the calf muscles - which are tight in many women - to relax." Higher heels (11/2in-21/2in) are best worn for limited periods, say around three to eight hours, providing you are having sitting breaks for half that time. At other times, wear lower heels.
Having a bad foot day?
You may be surprised to know that your feet are not supposed to hurt and most foot problems can be resolved with early medical intervention. If you are having a foot problem, you are not alone; twenty percent of the population seeks help for a foot problem every year.
Shocking good news for chronic heel pain
Do you or someone you know have chronic heel pain? This condition is known medically as Plantar Fasciitis.
If your answer is yes to the above question, you may be interested in a relatively new alternative treatment called extracorporeal shock wave therapy (ESWT), a non-invasive procedure in which strong sound waves are directed at the area of pain. The device used for ESWT is very similar to the one currently used in non-surgical treatments of kidney and gall-bladder stones. This device generates strong shock waves at the treatment site. The ESWT treatment takes about 30 minutes and is performed under local anaesthesia and/or 'twilight' anaesthesia. ESWT is an out-patient procedure and does not require an overnight stay in the hospital.
In the U.S. alone, about two million cases of heel pain are reported each year and many are debilitating. ESWT has proven to be extremely effective in treating such conditions as plantar fascitis, commonly known as heel spurs. ESWT has also been used to treat tennis elbow and Achilles tendonitis.
Finally, there's effective treatment for your chronic heel pain or other chronic orthopedic conditions...without open surgery or lengthy therapy sessions.
Extracorporeal Shockwave Therapy (ESWT) is restoring patients with chronic heel pain syndrome (Plantar Fasciitis) to a normal, active lifestyle with a single treatment. A non-invasive procedure similar to lithotripsy used in the treatment of kidney stones, ESWT uses therapeutic pressure waves to relieve the pain and inflammation to the ligament on the bottom of the foot. Americans can now experience this effective technology that has been used internationally for a decade to treat a variety of chronic musculoskeletal conditions. Shockwave therapy uses high intensity sound waves to rid my patients of severe debilitating heel pain.
What is ESWT?
Extracorporeal Shockwave Therapy, or ESWT, treats chronic heel pain syndrome (Plantar Fasciitis) and other tendonitis conditions. It is a non-invasive procedure in which therapeutic pressure waves are directed at the area of pain. In the case of chronic heel pain, energy is transmitted through electro-magnetic shockwaves and are directed at the plantar fascia, the ligament running along the bottom of the foot. The shockwaves stimulate a healing response in the affected non-healing tissue. The result is a reduction in inflammation and pain from the affected ligament.
Patients experience a short recovery period, often with few or no side effects. Most patients experience relief from the pain right away, but for others, the full results from a single treatment may be experienced in one to three months. Results typically last forever.
Our participating podiatrists and orthopedists utilize our Extracorporeal Shockwave Therapy (ESWT) services for a variety of podiatric and orthopedic ailments, including plantar fasciitis. To learn more about Shockwave Therapy, click here.
Frequent Questions about EWST
What is Extracorporeal Shock Wave Therapy or ESWT?
ESWT is a new procedure used to treat chronic heel pain syndrome and other tendonitis conditions. It is a non-invasive procedure in which therapeutic pressure waves are directed at the area of pain. The technology has been used in the successful treatment of hundreds of thousands of patients worldwide. One of the advantages of ESWT is that the risks associated with open surgery may be avoided.
What can be expected when a patient has ESWT?
ESWT is a non-invasive procedure and is performed on an outpatient basis. The procedure lasts approximately 30 - 45 minutes. During the treatment, the physician targets and directs therapeutic pressure waves to the affected area. The benefits of the treatment may take from one to three months to be fully effective. Dr. Sherman will schedule continued care visits and post-ESWT continuance therapy.
Is the ESWT procedure painful?
Prior to treatment, local anesthesia is administered to make the patient more comfortable. Afterward, there may be temporary discomfort.
What happens after the procedure?
The ESWT procedure is performed on an outpatient basis. Each patient is required to have a designated driver or guardian. Patients should be able to return to normal daily activities after a brief recuperative period. Consultation with Dr. Sherman will clarify any post-ESWT limitations or specifics that may apply to your case. Dr. Sherman will schedule continued care visits and post-ESWT continuance therapy.
Does insurance cover the treatment? Are there any other payment options?
Extracorporeal shock wave therapy is gaining acceptance in the United States by major insurance carriers. Patients should request coverage for this therapy through Dr. Sherman's office or by directly contacting their insurance carrier to determine reimbursement. Direct patient payment and procedure financing may also be available.
Who is eligible for ESWT?
Generally, candidates for ESWT include patients with chronic heel pain syndrome or other tendonitis conditions in which the pain has lasted for more than several months without responding to conservative therapies such as strengthening exercises, stretching, massage, splints, taping, cortisone injections and anti-inflammatory medications.
What are the major advantages of ESWT (Extracorporeal Shock Wave Technology) vs. older open heel pain surgery?
- There is no cutting with this procedure. There are no major complications that you could get with ESWT surgery.
- Healing time with ESWT is 1,000 times faster. Heel spur surgery can take six months or more to heal.
- There is no risk of permanent nerve damage or joint damage to the foot with ESWT.
- No loss of time from work, which can occur with older open type heel spur surgery.
- With heel spur surgery, you can have severe post-operative pain. This doesn't happen with ESWT.
- "The most important reason to have ESWT over surgery is that you can replace the money but you can't replace the complications that possibly could occur with surgery."
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The Mindray DP-6600 is a state of the art diagnostic ultrasound unit that I utilize in my office, in lieu of x-rays. The DP-6600 is utilized for the diagnosis of tendonitis, plantar fasciitis, tendon ruptures, soft tissue masses such as fibromas, bursitis, cysts and ganglions, Morton's neuroma and other nerve tumors, capsulitis, plantar plate dysfunction, foreign bodies, bone injuries such as stress fractures, muscular injuries, ligament injuries, joint pathology and ultrasound guided injections and aspirations. The DP-6600 works via ultrasound waves and eliminates radiation exposure to the patient. A little sweat is a good thing. In fact, brain-imaging studies in humans and neurochemical studies in animals have shown evidence that sweat inducing exercise actually makes a stronger brain. However, in a society that demands that you "never let them see you sweat," excessive perspiration, known medically as hyperhidrosis, can have physiological consequences such as cold and clammy hands, smelly feet and underarms, dehydration, and skin infections secondary to maceration. |
Excessive sweating increases anxiety and stress in both occupational and social situations. There are even some “fiscal” consequences as well, including ruined clothing and shoes. Read More Click Here.
Sculptra and Restylane: “Pillows For Your Feet”
- Do you suffer from hard, bony prominences on your feet?
- Is touching the floor barefoot painful?
- Do the balls of your feet burn?
As we age, fat is often lost under the ball of the foot. This lost padding can be replaced with Sculptra or Restylane. Sculptra is made up of microscopic particles of polylactic acid (the same material used in some absorbable sutures). Restylane uses a form of hyaluronic acid. Hyaluronic Acid is the same in all animal species and therefore has a very low allergenic potential.