Friday, May 28, 2010

Podiatry & Gout

Gout is a disease caused by the buildup of uric acid in the joints. It results from an elevated blood level of uric acid (hyperuricemia), which occurs when the liver produces more uric acid than the body can excrete in the urine, or when a diet high in rich foods produces more uric acid than the kidneys can filter from the blood.

Over time, uric acid in the blood crystallizes and settles in the joint spaces, causing swelling, inflammation, stiffness, and pain. Gout usually affects the first metatarsal phalangeal joint of the big toe (hallux) or the ankle joints.

According to the National Institutes of Health (NIH), gout affects approximately 2.1 million people in the United States. The disease is more common in men between the ages of 40 and 50, and in women, incidence increases after menopause. The condition is rare in children and young adults.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, approximately 18% of people who develop gout have a family history of the condition. Diseases and conditions that increase the risk include diabetes, obesity, kidney disease, and sickle cell anemia.

Regularly drinking alcohol interferes with the removal of uric acid from the body and can increase the risk for developing gout.

Other risk factors include the following:
-Exposure to lead in the environment
-High dietary intake of rich foods that contain purine (e.g., cream sauces, red meat, sardines, liver, scallops)
-Medications that may interfere with the body's ability to remove uric acid (e.g., aspirin, diuretics, levodopa [used to treat Parkinson’s Disease])

Gout usually develops in the joint of the first toe (i.e., the big toe, or hallux). It also can affect the ankle or knee.

Common symptoms of gout include the following:

Touching or moving the toe may be intensely painful and patients often say that having as much as a bed sheet over the toe increases the pain. Symptoms of gout develop quickly (sometimes in 1 day) and typically occur in only one joint at a time. Rarely, symptoms develop in two or three joints simultaneously. If widespread symptoms occur, the condition is probably not gout. If left untreated, gout can damage joints and cause disability.

Prevention is the best defense against gout. Medication (e.g., small doses of NSAIDs, colchicine, allopurinol [Zyloprim®], probenecid) may prevent continued accumulation of uric acid in the joints and further attacks. Avoiding alcohol and rich foods that are high in purine (e.g., scallops, sardines, red meat, sweetbreads, gravy, cream sauces) also may help to prevent the condition.

Other preventative measures include the following:
-Drink plenty of fluids (especially water)
-Exercise regularly
-Maintain a healthy diet and healthy body weight
-See a physician regularly

Call to make an appointment with one of our podiatrists today if you believe you may be suffering from any of these symptoms.

Community Foot Care: 937-322-7607 or 937-426-9500

Thursday, May 27, 2010

EX-PAIN! Exercises

Calf and Foot Strengthening Exercises
Strengthening your calf muscles and foot muscles will prevent plantar fasciitis and other types of heel pain. By strengthening your muscles, your stride when walking will improve and pronation can be corrected.

Stand on a stair with one hand on a wall or railing for support, keeping the toes on the stair and let the heels hang. Gain balance in this position, then slowly lift up onto your toes, then slowly return back to the neutral position. The exercise should be felt in the calf muscles and along the back of the ankle. Slowly lift up onto the toes, then lower the heels back to the original starting position. This exercise should be repeated 10 times up and down for 3 sets, a total of 30 lifts.

Another great trick is to stand on your tip toes and slowly walk forward and backwards taking slow small steps. Stand very tall and keep your hands at your side. Roll your weight onto your tip-toes and lift your heels. Gain balance and see how many 10-12 inch steps you can take forward, resting after about 10 steps (5 on each foot). Then, try and repeat the same exercise but walking backwards.

Plantar Stretch
A great stretch to lengthen the plantar fascia ligament and prevent morning pain is plantar stretch. This stretch is designed to treat and prevent heel pain and plantar fasciitis and when done in the morning alleviates morning pain.

Start with both feet in front of you and bend one leg at the knee. Grab the ball of the foot with one hand over the toes and pull towards your chest. By pulling the ball of the foot and not the just the toes this will create a good stretch along the arch of the foot.

Stretching the plantar fascia ligament will aid in the treatment of plantar fasciitis by developing length in the ligament. Stretch the arch of the foot by taking one hand and pulling the toes back toward the shin for a count of 10. Stretching will alleviate tension along the plantar fascia ligament and prevent the soft tissues of the foot from tightening up.

Hold this stretch on each foot for 15-20 seconds and repeating on both sides 3 times, once a day.

As always, consult with your podiatric physician before attempting these exercises!
Community Foot Care : 937-322-7607 or 937-426-9500

Wednesday, May 26, 2010

Bare Necessities!

For years, going barefoot has seemed alluring. Individuals long to be barefoot on the beach. Additionally, there are runners that prefer to exercise barefoot. Even little children are constantly kicking their shoes off. While going barefoot may be appealing, it also has its risks. Walking or standing without shoes will allow your feet to become more susceptible to heel pain.

No Support

When you are barefoot, your feet have limited support. The fat pad along the sole of your foot becomes the only protection available. This padding guards your plantar fascia. After you walk barefoot on a hard surface for a substantial amount of time, the fat pad might not be effective at protecting the fascia. This could result in inflammation of the fascia, which often leads to heel pain.

Walking On Your Toes

Also, typically when you walk barefoot for an extended period of time, you stop walking normally. The average person initially steps on the ball of their foot. However, after too much time without shoes, you might begin to walk abnormally. In fact, many people begin to walk on their toes. This actually places added stress on the plantar fascia causing more heel pain.

Wear Your Shoes

Because heel pain is so prevalent among individuals that walk barefoot, wearing shoes is important. You need the support that your shoes provide. While there may be times where you will be required to take off your shoes, try to support your feet as much as possible. And make sure that you are wearing shoes that have proper support - not ones that are worn out and old.

The fact of the matter is, whether you suffer from heel pain or not, going barefoot is not recommended, particularly outside. In addition to leaving your feet with a severe lack of support, going barefoot outside exposes your entire foot; it is easy to cause a surface wound (or worse) to your skin. These minor injuries can cause major problems, particularly for diabetic patients who have a more difficult time healing.

Monday, May 24, 2010

Summer Ready Toes!

With summer swiftly approaching, most of us are readily disregarding our bulky boots for convenient and trendy open- toed shoes. The presence of discolored toenails, however, can put a damper on your sunny plans. 

If you notice yellow, discolored, brittle, or thickened toenails, you may be suffering from fungal nails. The medical terms for this type of fungal infection are onychomycosis or tinea unguium. Fungal infections of the nail affect up to 3% of the population, mainly in developed countries.

A fungal nail is an unsightly infection caused by many varying microscopic organisms. Fungi can attack your nails through small cuts in the skin around your nail or through the opening between your nail and nail bed. These organisms thrive in warm, dark, moist environments; the perfect environment provided by your socks and shoes. Although this infection is usually not serious, it can lead to more serious illnesses and issues, particularly if you suffer from a compromised immune system or diabetes. It is also important to note that not every thickened, discolored nail is a fungal infection; therefore, it is important that infections are properly diagnosed and treated by consulting your podiatrist.

Risk Factors for Fungal Nail Infections
-Tight footwear keeps the toes warm and moist; a perfect environment for fungi to grow.
-Communal showers can expose the feet to fungi.
-Diseases that influence the immune system like AIDS and diabetes can make it easier for a fungal infection to start and thrive.

Community Foot Care realizes that with summer here, it's sometimes important to have healthy and pretty toes!  We recommend  Dr.’s Remedy Enriched Nail Polish.

Dr.'s Remedy Enriched Nail Polishes appeal to health-conscious women because it removes the potentially harmful additives found in most commercial nail polishes. The product is created, tested, and prescribed by doctors. This polish lasts as long as polishes containing harmful ingredients but provides numerous advantages. There’s no icky yellow formaldehyde tint left behind, plus it contains anti-fungal ingredients that help protect nails from fungal diseases; making it not only curative, but preventative in the fight against nail infections. With Dr.’s Remedy you can have beautiful and healthy nails! Dr.’s Remedy Enriched Nail Polish comes in 16 beautiful and healthy shades! Please visit to view this product. Once you are at our site, simply click on the Our Doctor Store icon to select products specific to the problem you may have. This product is listed under ‘Fungal Nail Polishes’.

Friday, May 21, 2010

Bummed about Your Bunions?

Even though bunions are a common foot deformity, there are misconceptions about them and many people may unnecessarily suffer the pain of bunions for years before seeking treatment.

A bunion (also referred to as hallux valgus or hallux abducto valgus) is often described as a bump on the side of the big toe, but a bunion is more than that; the visible bump actually reflects changes in the bony framework of the front part of the foot. The big toe leans toward the second toe, rather than pointing straight ahead. This throws the bones out of alignment – producing the bunion’s “bump.”

Bunions are a progressive disorder. They begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the characteristic bump, which becomes increasingly prominent. Symptoms usually appear at later stages, although some people never have symptoms.

Bunions are most often caused by an inherited faulty mechanical structure of the foot. It is not the bunion itself that is inherited, but certain foot types that make a person prone to developing a bunion.

Although wearing shoes that crowd the toes won’t actually cause bunions, it sometimes makes the deformity get progressively worse. Symptoms may therefore appear sooner.

Symptoms, which occur at the site of the bunion, may include:
Pain or soreness
Inflammation and redness
A burning sensation
Possible numbness

Symptoms occur most often when wearing shoes that crowd the toes, such as shoes with a tight toe box or high heels. This may explain why women are more likely to have symptoms than men. In addition, spending long periods of time on your feet can aggravate the symptoms of bunions.

Community Foot Care would like you to know that, although surgery is an option available to most, there are many alternatives to bunion treatment depending upon the patient. Please consult your podiatric physician for proper diagnosis and treatment.

Thursday, May 20, 2010

Facts about Flatfoot

Community Foot Care is dedicated to providing not only quality care to our patients, but also quality education. Many of our patients question the causes and symptoms of flat feet. We are happy to provide some facts on the subject. 

You have flatfeet when the arches on the inside of your feet are flattened, allowing your entire foot to touch the floor when you stand up. A flat foot is normal in infants and toddlers, because the foot's arch hasn't yet developed. Most people's arches develop throughout childhood, but some people never develop arches. This is a normal variation in foot type, and people without arches may or may not have problems.

Arches can also fall over time. Years of wear and tear can weaken the posterior tibial tendon, which runs along the inside of your ankle, from above your ankle to your arch.

Factors that can increase your risk of flatfeet include obesity, traumatic injury to your foot or ankle, rheumatoid arthritis and aging.

Flatfeet can sometimes cause problems in your ankles and knees because the condition can force your ankles to turn inward and this throws off the alignment of your legs. If you aren't experiencing any pain, no treatment is usually necessary. However, some people do experience these common symptoms: foot pain (particularly in the heel or arch area), difficulty standing on tiptoe, and/or swelling along the inside of the ankle.

Orthotics are commonly used to treat flatfoot. Orthotics are devices placed in the shoes that are customly fit to your foot. Community Foot Care is happy to supply affordable, efficient, and successful orthotics to our patients. We supply orthotics at all of our locations in the Springfield and Dayton area.

It is important to note that flatfoot is unique to each patient and has many different causes and treatments. Call Community Foot Care, today, for a consultation with our podiatrists in order to receive proper diagnosis and treatment of your podiatric issues.

Springfield: 937-322-7607                   Dayton: 937-426-9500

Wednesday, May 19, 2010

Basic Diabetic Foot Care

According to the American Diabetes Association, about 15.7 million people (5.9 percent of the United States population) have diabetes. Nervous system damage (also called neuropathy) affects about 60 to 70 percent of people with diabetes and is a major complication that may cause diabetics to lose feeling in their feet or hands.

Community Foot Care understands how even minor foot problems are a big risk in diabetics.

With a diabetic foot, a wound as small as a blister from wearing a shoe that's too tight can cause a lot of damage. Diabetes decreases blood flow, so injuries are slow to heal. When your wound is not healing, it's at risk for infection. As a diabetic, your infections spread quickly. If you have diabetes, you should inspect your feet every day.

Here is Community Foot Care’s advice for taking care of your feet:

• Always keep your feet warm.
• Don't get your feet wet in snow or rain.
• Don't put your feet on radiators or in front of the fireplace.
• Don't smoke or sit cross-legged. Both decrease blood supply to your feet.
• Don't soak your feet.
• Don't use antiseptic solutions, drugstore medications, heating pads or sharp instruments on your feet.
• Trim your toenails straight across. Avoid cutting the corners. Use a nail file or emery board. If you find an ingrown toenail, contact our office.
• Use quality lotion to keep the skin of your feet soft and moist, but don't put any lotion between your toes.
• Wash your feet every day with mild soap and warm water.
• Wear loose socks to bed.
• Wear warm socks and shoes in winter.
• When drying your feet, pat each foot with a towel and be careful between your toes.
• Buy shoes that are comfortable without a "breaking in" period.

As a diabetic, it is pertinent you have regular check-ups with your podiatric physician. Please call to schedule your diabetic consultation today with Community Foot Care.

Community Foot Care
Springfield: 937-322-7607
Dayton: 937-426-9500

Tuesday, May 18, 2010

Stuggling to be Light on Your Feet?

At Community Foot Care, we’ve noticed patients from all of our Springfield and Dayton area locations have been calling inquiring about the safety of new lower body toning footwear such as Reebok’s EasyTone sneaker. So, we decided to take a look at the research on these tennis shoes ourselves.

Can you give your muscles a better workout simply by changing your shoes? Reebok claims you can... The new EasyTone walking shoe is a provocative new marketing campaign which allegedly leaves leg and buttock muscles better toned than regular walking shoes; and consumers, including patients of Community Foot Care, are buying it… literally! Officials from Reebok say the EasyTone is the company’s most successful new product in at least five years.

While most athletic shoes offer support and cushioning, the new muscle-activating shoes are engineered to create a sense of instability. Design elements, like curved soles and Reebok’s “balance pods”, are said to force the wearer to engage stabilizing muscles further, supposedly resulting in additional toning for calf and hamstring muscles.

In an era where thin is in, many are trying to find the newest way to lose weight, but the fact of the matter is, unless you have a medical condition – there is no secret. Community Foot Care would like to remind you that an increase your activity and a decrease your caloric intake is the only way. So spend that shoe money on a gym membership, and focus on being healthy and happy! Furthermore, it is important to consult with your podiatrist before wearing these shoes if you have any foot or ankle problems. As each patient is different, some may benefit from this shoe, and some may encumber their podiatric treatment by wearing these shoes.

Call our office today and make an appointment to discuss orthotics, diabetic footwear, or even Rx crocs with your podiatrist!

Community Foot Care
Dr. Thomas, DPM; Dr. Guehl, DPM; Dr. Dotter, DPM

Springfield location:
Centerville, Beavercreek, Vandalia, Dayton’s Linden Ave., or Dayton’s N. Main St. Location:

Monday, May 17, 2010

Mourning Memorial Day Diets?

Being diabetic can be frustrating because, let’s face it, the food that is bad for you is usually the food that is most enjoyable. Community Foot Care understands the challenges our diabetic patients face. The physicians and staff at our six locations in Beavercreek, Vandalia, Centerville, Springfield, and N. Main St. and Linden Ave., Dayton locations understand the pressures you face each day… especially during the holiday gatherings. We would like to remind our patients that your diabetic foot care starts with maintaining healthy glucose levels. Here is a Community Foot Care approved yummy recipe for your Memorial Day enjoyment!


1 cup( (150 g) low fat biscuit and baking mix (70% less fat than regular mix)
1/2 cup (120 ml) low fat buttermilk or skim milk
2 tablespoons (30 g) Spoon One Sugar Replacement
1/2 teaspoon (2.5 ml) vanilla extract 
butter-flavored cooking spray
12 strawberries, cleaned and sliced thin
at free whipped topping

1. Preheat oven to 400° F (200°C), gas mark 6.
2. Place the biscuit mix, milk, sugar substitute and vanilla extract in a bowl. Mix until just combined.
3. Roll out the dough on a flowered board and cut with a 2 3/4-inch (6.7 cm) biscuit cutter into 4 biscuits.
4. Place onto a nonstick cookie sheet which you have coated with cooking spray. Bake about 12 minutes, until nicely browned.
5. To serve, cut each warm biscuit in half and top lower half with three sliced strawberries, saving one slice for garnish. Cover with the top of the biscuit. Place a dollop of whipped topping on top and garnish with reserved strawberry.

Per serving: 146 calories (13% calories from fat), 4 g protein, 2 g total fat (0.6 g saturated fat), 29 g carbohydrates, 1 g dietary fiber, 1 mg cholesterol, 381 mg sodium

Call us for any and all of your diabetic foot care needs!

Springfield: 937-322-7607
Dayton: 937-426-9500

Thursday, May 13, 2010

Death by Pedicure?!

With so many lawsuits connected to deaths, chronic infections and disfigurement from pedicures; you would think the public would be clamoring for reform… Just the opposite, most consumers completely blow off the risks and have the "it won't happen to me" attitude.  Spring Day Spa is taking action to ensure our customers are safe at our Beavercreek, Centerville, and Springfield salon locations.

Approximately $6 Billion dollars are spent on spa related nail care every year, making it a huge industry. A pretty pedicure can be accompanied by a take-home surprise: hepatitis, cutaneous herpes, warts, HIV, bacterial and fungal infections. These can be deadly, especially if the client is diabetic or has a compromised immune system.

A 43-year-old San Jose, California woman had a small cut on her toe that led to her death from a skin infection in 2004. A 46-year-old Ft Worth, Texas mother left the pedicure salon with a small abrasion on her heel from a pumice stone in July 2005 and died of a staph related illness. Her family is still embroiled in a wrongful death lawsuit...

The fact of the matter is that, without proper care, this can happen to anyone. It is important you have nail work done at a salon that is educated and serious about the safety of their clients. Our Beavercreek, Springfield, and Centerville salons are medical grade, using autoclaves to sterilize instruments between each client. Spring Day Spa's Nail Technician is licensed and experienced, as well as trained and supervised by our physicians. Take your nail care seriously, as it very well can turn into a life or death situation!

For an appointment or more information, please contact us! Your SAFETY and happiness is our main priority!

Spring Day Spa
Springfield: 937-688-4381
Beavercreek or Centerville: 937-242-7001