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Larry Cohen, DPM

June 2020

Monday, 29 June 2020 00:00

Morton's Neuroma

A neuroma is a thickening of nerve tissue and can develop throughout the body.  In the foot, the most common neuroma is a Morton’s neuroma; this typically forms between the third and fourth toes.  The thickening of the nerve is typically caused by compression and irritation of the nerve; this thickening can in turn cause enlargement and, in some cases, nerve damage.

Neuromas can be caused by anything that causes compression or irritation of the nerve.  A common cause is wearing shoes with tapered toe boxes or high heels that force the toes into the toe boxes.  Physical activities that involve repeated pressure to the foot, such as running or basketball, can also create neuromas.  Those with foot deformities, such as bunions, hammertoes, or flatfeet, are more likely to develop the condition.

Symptoms of Morton’s neuroma include tingling, burning, numbness, pain, and the feeling that either something is inside the ball of the foot or that something in one’s shoe or sock is bunched up.  Symptoms typically begin gradually and can even go away temporarily by removing one’s shoes or massaging the foot.  An increase in the intensity of symptoms correlates with the increasing growth of the neuroma.

Treatment for Morton’s neuroma can vary between patients and the severity of the condition.  For mild to moderate cases, padding, icing, orthotics, activity modifications, shoe modifications, medications, and injection therapy may be suggested or prescribed.  Patients who have not responded successfully to less invasive treatments may require surgery to properly treat their condition.  The severity of your condition will determine the procedure performed and the length of recovery afterwards.

Published in Featured
Monday, 22 June 2020 00:00

Heel Spurs

Heel spurs are the result of calcium deposits that cause bony protrusions on the underside of the heel. Heel spurs are usually painless, but they have the potential to cause heel pain. Heel spurs tend to be associated with plantar fasciitis, which is a condition that causes inflammation of the band of connective tissue that runs along the bottom of the foot. They most often occur to athletes whose sports involve a lot of running and jumping.

Some risk factors for developing heel spurs include running and jogging on hard surfaces, being obese, wearing poorly fitting shoes, or having walking gait abnormalities.

It is possible to have a heel spur without showing signs of any symptoms. However, if inflammation develops at the point of the spur’s formation, you may have pain while walking or running. In terms of diagnosis, sometimes all a doctor needs to know is that the patient is experiencing a sharp pain localized to the heel to diagnose a heel spur. Other times, an x-ray may be needed to confirm the presence of a heel spur.

Heel spurs can be prevented by wearing well-fitting shoes that have shock-absorbent soles. You should also be sure that you are choosing the right shoe for the activity you want to partake in; for example, do not wear walking shoes when you want to go on a run. Additionally, maintaining a healthy weight can be beneficial toward preventing heel spurs, as it will prevent an excess amount of pressure being placed on the ligaments.

There are a variety of treatment options for people with heel spurs. Some of these include stretching exercises, physical therapy, shoe inserts, or taping and strapping to rest stressed muscles and tendons. If you have heel pain that lasts longer than a month, don’t hesitate to seek help from a podiatrist. Your doctor can help you determine which treatment option is best for you.

Published in Featured
Monday, 15 June 2020 00:00

Effect of High Heels on the Feet

For hundreds of years, women have been wearing various kinds of high heels for aesthetic reasons. Women who wear high heels appear to be taller and have longer and thinner legs, and the wearer’s gait and posture changes. Though high heels have had an association with femininity and have kept them popular over the years, there are definite health problems caused by wearing them too frequently.

The motion of the ankle joints is limited when heels are worn. The ankle joint is very important to the body when it comes to walking. Because of their location, these joints have a great deal of weight put on them. Thus, it is very important to keep them as healthy as possible. The Achilles tendon is the main tendon in the ankle. Wearing high heels too often, studies have shown, can cause the calf muscle and Achilles tendon to shorten and stiffen. This can cause problems when shoes without heels are worn.

By putting a great deal of pressure on the ball of the foot and by forcing the toes into a small toe box, high heels can cause or may worsen many foot problems. These include corns, hammertoe, bunions, Morton’s neuroma and plantar fasciitis.

Not only does wearing high heels regularly have negative effects on the feet, the rest of the body can suffer as well. The knees, one of the most important joints in the entire body, can be affected by wearing high heels.  High heels can cause the knees to stay bent all the time. Also, it can cause them to bend slightly inward as well. Doctors believe that women can suffer from osteoarthritis later in life because of constantly walking like in high heels. By limiting the natural motion of the foot during walking, high heels also cause an increased in stress on the knees.

Similarly, high heels can cause the back to go out of alignment. If high heels are worn constantly, the spine’s ability to absorb shock can cause continued back pain. They can compress the vertebrae of the lower back, and can overuse the back muscles.

However, this is not to say that high heels can never be worn. If worn occasionally and not often, they will not cause serious problems. They should not be worn every day. It’s important to wear them modestly to avoid the long-term physical health problems of the feet, knees, ankles, and back mentioned above.

Published in Featured

In 2014, the American Podiatric Medical Association surveyed 1,000 American adults and found that half of all respondents lived with foot pain. Fortunately, there are ways to avoid foot problems such as following a daily footcare routine and wearing proper footwear at work.

If you have a job that requires you to be on your feet, it is best that you do not wear flat sole shoes. Your heel should be slightly elevated (less than 2 inches, but at least ¼-inch) if you are going to be standing for a prolonged period. You should also make sure that the shoes you wear are not too small. Tight shoes may cut off circulation to your feet, which will result in pain and blisters. It is always best to purchase fitted shoes later in the day, because the feet tend to swell as the day progresses. It may also be helpful to buy shoes a half size larger if you plan on wearing custom orthotics or arch supports.

Your muscles may become stiff when you are constantly standing up. It is important to take breaks every hour to stretch and relax. One tip is to perform calf raises, because this exercise will help improve your circulation. To perform this stretch, you first need to stand on the edge of a step with your abdominal muscles pulled inward. You then need to grip the step with the balls of your feet with your heels hanging over the edge. Next, try to raise your heels above the step by a few inches while standing on your tiptoes; hold this pose for a second. You should then lower your heels back even to the platform. These calf raises should be done ten times for full effectiveness.

You should also take care of your feet while you are at home. One of the best ways to prepare your feet for a long day of work is to soak them in ice water. Doing so for 20 minutes will help fight the swelling and inflammation that results from being on your feet at work.

Nevertheless, if you are experiencing pain in your feet, you should seek help from your podiatrist. Your doctor will help treat any ailments you may have in addition to helping you prevent any other ailments from developing in the future.

Published in Featured
Monday, 01 June 2020 00:00

PRP Injections in the Feet

Platelets are cells in the blood that help form clots to stop bleeding. PRP (Platelet-rich plasma) utilizes an individual’s own concentrated platelets, which has many growth factors. These growth factors are used to heal injuries and relieve symptoms. At times, PRP may eliminate the need for other medications or surgery. Many famous athletes such as Tiger Woods and Rafael Nadal have used PRP injections and experienced success.

PRP can be created in approximately 25-30 minutes. The process starts with drawing a small amount of blood from the patient, and then placing it into a centrifuge. A centrifuge is a machine that spins the blood at a high speed to separate the red blood cells from the concentrated platelets. The concentrated platelet rich plasma is the PRP that is used in the treatment process.

This regenerative treatment can treat many different types of ailments. Chronic tendon injuries, acute ligament and muscle injuries, and fractures may be treated with PRP. PRP works by being injected into the injured area. If someone has Achilles tendonitis, the PRP will be mixed with an anesthetic and this combination can be injected directly into the inflamed tissue. The pain may be more severe after the first week or two, and it may take several weeks for the patient to experience improvement.

In some cases, PRP may be used along with surgery to improve healing. For example, if someone with a torn heel cord requires surgery, the healing process may be expedited by treating the injured area with PRP during surgery. However, this must be done in a specific way in which the PRP is stitched into the torn tissues.

Prior to using PRP injections, you should weigh the pros and cons to decide whether this treatment is right for you. Some of the benefits are that areas of the body that have limited blood supply, such as the feet, will receive a boost in oxygen and nutrients. Another benefit is that the injections will prevent further tissue degeneration. However, there are many drawbacks to using PRP. One of the cons is that it may take several weeks for you to feel its beneficial effects. Another downside is that many insurance companies do not cover the treatment because it is experimental. The approximate cost of PRP may range from $250-$800 depending on how many injections are necessary.

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