John Hollander, DPM

What you need to know about Raynaud’s Disease- the disease that turns your fingers and toes blue

The minute your body is exposed to cold temperatures, or you touch something cold, your extremities start to turn blue!  Have you experienced this, or know someone that has?  It could be a case of Raynaud’s Disease.  Fingers and/or toes that become numb, prickly or sting and also change color, such as white or blue when exposed to cold temperatures, are often the result of vasoconstriction (extreme narrowing of the blood vessels).

The disease causes an interruption of blood flow to the fingers, toes, nose, lips and/or ears when a spasm occurs in the blood vessels of these areas. Spasms are caused by exposure to cold or emotional stress.  Typically, the affected area turns white, then blue, then bright red over the course of the attack.  There may be associated tingling, swelling, or painful throbbing.  The attacks may last from minutes to hours.  In severe cases, the area may develop ulcerations and infections, which can lead to gangrene.

Here are some tips on avoiding a Raynaud’s attack:

  1. Manage stress.
  2. Dress warmly and in layers.
  3. Limit your consumption of alcohol and caffeine.
  4. In cold weather or when exposed to air conditioning or cold temperatures wear gloves. Mittens are even better protection. Use these even when handling frozen or refrigerated foods.
  5. Carry hand and foot warmers.
  6. Use insulated drinking glasses or mugs. Place a napkin or insulating material around them to protect your fingers from becoming cold.
  7. Place hands under warm (not hot) water to warm them up quickly.
  8. Don’t smoke. Smoking narrows blood vessels and makes Raynaud’s worse.
  9. Swing arms around in a windmill fashion to get the circulation going quickly.

If you believe you are suffering from Raynaud’s or have any concerns call Dr. Hollander today for an evaluation, 707-578-1222.

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6 Signs It’s Time to Replace or Refurbish Your Orthotics

Do you have a pair of orthotics that are worn down, flat and no longer provide any support? If so, chances are it is time to refurbish or replace your orthotics.

Orthotic refurbishing helps extend the life of your orthotics.  Refurbishing can include replacing top covers or the addition of extra soft cushioning under the heel or the ball of the foot. Everything can be replaced to add more cushion and modifications to address specific foot pain.  If there is a new problem, Dr. Hollander can recommend additional modifications.

Signs that may indicated it is time to refurbish or replace your orthotics include:

-Worn out top cover, which provides comfort to the surface of your foot

-Pain in your feet, ankles, legs or back- even when wearing your orthotics

-Orthotic is flat and no longer holding shape

-Age. Most orthotics last between one to five years, depending upon the frequency of use and material type

-Damage, signs of cracking or breakage to the orthotic

-Shoe wear is not even. Orthotics are designed to keep you balanced, so if your shoes are wearing unevenly, that could be a sign it’s time to refurbish or replace them.

Before you go to put on your shoes for the day, take out your orthotics and examine them. See if one of these signs pertain to your orthotics.  If they do, then you know it’s time to see Dr. Hollander.

What a better way to start off this new season than having a pair of comfortable orthotics and healthy feet.

Call or stop by our office today to schedule an appointment with Dr. Hollander to have your orthotics evaluated. Make your feet happy!  You can reach our office Monday- Friday at (707) 578-1222 or schedule online through our online scheduler.

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CBD Rapid Cooling Cream- Now Available!

At Dr. Hollander, DPM we are always looking for advanced methods and the newest technology in podiatric care.  Dr. Hollander is especially adamant about NOT prescribing opioids because he knows the risks associated with the drug and that there are so many other effective methods to pain management.

Introducing MEDTERRA’s CBD Rapid Cooling Cream, now available in our office for purchase, no prescription needed.

MEDTERRA’s CBD Rapid Cooling Cream is a powerhouse combination of CBD and certified organic ingredients. This topical cream provides a rapid cooling effect, perfect for sore muscles and tight joints. Use at the end of the day, after a workout or hitting the links for quick comfort.

Tested in the USA, MEDTERRA’s high quality, hemp-derived CBD is fully compliant under the Kentucky Department of Agricultural Industrial Hemp Pilot Program and is certified by the U.S. Hemp Authority.

Their whole-plant, CO2 extraction process allows for them to draw CBD from the plant material and filter out unnatural and undesired substances, maximizing the pure CBD concentration for you. The CBD is 99.6% pure!  MEDTERRA states that their CBD products are third-party tested, completely legal and contain 0% THC.

Each 3.4 fl oz. bottle contains 100mls of cream, allowing for ample applications of soothing, long-lasting comfort.  Bottles are available in 250mg and 750mg strengths depending upon your specific needs.

The next time you’re feeling that ache or pain, consider MEDTERRA CBD Rapid Cooling Cream to temporarily resolve your discomforts.   Stop by our office Monday-Friday 8am-4pm at 95 Montgomery Dr. Ste 114, Santa Rosa, CA 95404.  For any questions about this product please call our office at (707) 578-1222.

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Why Use a Spiky Ball?

Have you ever tried to give yourself a foot massage when your feet are unbearably achy?  If so, you’ll know that it’s difficult because the angle that your feet and hands meet is quite limiting and often the strength of our fingers is minimal.  So, what do you do?  Many people have found success by using a spiky ball to massage their achy feet.  This blog post will tell you what you need to know about spiky balls, why you need to start using them and how to use them.

What is a spiky ball?

Spiky balls are beneficial tools most often used by physical therapists and now more frequently by athletes, to perform self-therapy on varying muscles of the body and to shorten recovery time.  Often spiky balls will be used on the feet to help treat tight arches, achy heels and plantar fasciitis.  Spiky balls are balls that come in varying sizes from lacrosse size to golf ball size, covered in small rounded spikes.  The firmness of the balls also varies depending upon the location of where the ball is to be used.

Why use a spiky ball? 

Using a spiky ball to address your aches and pains is very convenient, can be used just about any where and they are great at getting to those tough to reach muscles!  The spikes on the ball trigger pressure points on the feet that send a message to the pain receptors in the brain, thus resulting in temporary relief.  Massaging your feet with the spiky ball encourages blood flow to the area, which in turn breaks down painful adhesions (tears) in the plantar fasciitis and helps to speed up the healing process.  They are also great at reducing muscle tension in your calves, reducing edema in pregnant women and providing some relief to those with flat feet.

How to use a spiky ball?

When addressing plantar fasciitis, stand or sit with the ball under your arch. Roll the ball from your heel up to your toes with medium pressure. Repeat this motion back and forth several times.  This is a great technique for runners to use as well!  When the pad of your feet or your heel are particularly sore, use firm pressure and make small side to side motions with the ball.

Remember, self-massage with a spiky ball isn’t a permanent pain relief solution but rather an effective temporary solution. Use it as part of a healing regimen in combination with icing, stretching and orthotic inserts (if needed) for long-term results.  If you are still experiencing foot pain when practicing these methods at home, schedule an appointment with your podiatrist today!

While we don’t carry spiky balls in office, you can purchase them locally at Fleet Feet Santa Rosa or on Amazon!

Important Note: If you start to experience pain that does not subside or increases following use of the Spiky Ball please do not continue with these exercises until you have spoken with your podiatrist.

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Is Diabetic Burnout a Real Thing?

Whether you’ve lived with diabetes for most of your life or have just recently been diagnosed, diabetes burnout is real and it could happen to you!  By learning how to recognize the symptoms of burnout and tricks to putting a halt to them, you can prevent getting yourself  into risky life-threatening situations.

What is Diabetes Burnout?

Every day you have a routine you need to follow-  check your sugar levels, count your carbs,  take your medicine, visit your doctor and more.  That is a lot that you have to do in your day-everyday.  When you suddenly don’t want to do these “chores” anymore, the routine gets old, you slack on taking your insulin, you cancel your doctor appointments, or you stop self-care, that is diabetes burnout.  Experiencing diabetes burnout can also cause anxiety and stress and lead to life threatening situations.

What does diabetes burnout look like?

There are many ways to experience diabetes burnout including: feeling isolated or alone with diabetes, strong negative feelings towards diabetes,  avoiding some or all of your diabetes management tasks and self-care, feeling controlled by diabetes or, feeling like you have lost control of your diabetes.

What are the tools that one can use to combat diabetes burnout?

Don’t be perfect:  Everyone wants to have the exact “perfect” number for them and while it is good to strive for “happy” numbers, it’s just not practical to be perfect.  It is OK to be a little above or a little below your target numbers once in a while.  Try to stay within your healthy range but recognize that life happens and just try to do your best.

Set mini goals: If it all just seems to feel like it is too much, take one step at a time. Set yourself mini goals or tasks such as, checking your blood sugar after every meal or going for a short walk at the end of your day.

Tell your doctor you’re burned out:   Reaching out to your doctor about feeling burned out is a good thing. By doing so, the two of you can set up a new plan of action and new goals that are attainable for YOU!

Ask friends and family for help: They may not fully understand what it is like to be diabetic, unless they are diabetic themselves, but by including your family and friends in your struggles and achievements with diabetes, they can then be able to help cheer you on and provide emotional support when days are tough.  Also, educate your friends and family by making them aware of the comments they say to you. Their comments may have been said with good intentions, but in all reality, they can make you feel discouraged or isolated- let them know!

Relate through support: Reach out to fellow diabetics for tips and tricks and as a safe place to speak your frustrations.  Many others have been in the same boat and they will have ideas to help you get back on track. It is also a great way to support others like you.

To read or not to read, that is the question: If you are lacking motivation, try reading a book or article or support page for encouragement and to help you bust out of feeling burned out.  If you find yourself reading too much on the topic of diabetes take a break from it- disconnect from reading on the topic- instead, focus on activities that make you feel good like crafts, outdoor adventures or volunteering.

As Scott Coulter, writer for Diabetes Self Management said, “Diabetes is a tricky thing. It will always have the capacity to frustrate us, irritate us, scare us, and make us mad, but if we know how to work with our feelings we can avoid serious burnout, or at least catch it early and reverse it.”

If you think you may be experiencing diabetes burnout, talk to your doctor. Don’t put it off, you are worth the time and you deserve to be happy!

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Accessory Bones of the Foot

When you hear the word accessory, we tend to think of using pretty necklaces, rings or belts to enhance our outfits. But with accessory bones, they aren’t enhancing anything, but rather showing up in our x-rays as extra bones.

What is an accessory bone?

When we are born, most of our bones are cartilage that fuses and hardens over time.  In some cases, pieces of cartilage do not fuse together, but continue to harden into bone.  This lack of fusion and hardening is what causes an accessory bone.  Accessory bones are considered normal skeletal variations. In fact, there are up to 24 variations of accessory bones in the foot alone!

How do I know if I have an accessory bone?

Most people do not know that they have an accessory bone until it shows up on an MRI or X-ray, or foot pain is presence after a fracture, dislocation or more pressing conditions like osteoarthritis or tumors.   Unless the accessory bone itself is damaged, it will most likely be just be noted in your chart as an incidental finding.

How do you treat an accessory bone?

Unless the bone is injured or causing pain, there is no need to treat or remove it.  If there is pain, your doctor may prescribe an anti-inflammatory medication, rest, ice, steroid injections or physical therapy.  In some cases, surgical removal of the bone may be needed.

The next time you have an x-ray of your foot and discover an accessory bone there is no need to worry. Instead, embrace that little extra piece that makes you, you!

If you ever experience foot pain, contact your doctor if pain persists. Foot pain is not normal, and you don’t have to suffer through it. Call our office Monday through Friday at (707) 578-1222.

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Mirror, Mirror on the Floor: I See Diabetic Foot Checks in Store

Proper foot care for diabetics is crucial. Diabetic patients are more prone to foot problems such as:

  • Loss of feeling in their feet
  • Changes in the shape of their feet
  • Foot ulcers and sores that do not heal

Simple daily foot checkups can prevent serious problems in the long run. It is always better to catch them early rather than later.

Follow these simple everyday steps that will help prevent serious complications with your feet:

  1. Take care of your Diabetes.
  2. Check your feet every day. If you have trouble bending over use a plastic mirror to see your feet.
  3. Protect your feet from the elements by wearing proper shoes and socks. If you are unsure of what types of shoes and socks to wear, contact your podiatrist. Your questions are important and we want to help!
  4. Wash your feet every day. Be sure to keep the area between your toes dry, as that is an area fungus likes to live!
  5. Keep skin soft and smooth.
  6. Keep the blood flowing through your feet with light activities.

A simple search online for plastic mirrors will get you on your way to healthier feet. Start your diabetic foot checks today!!

At Doctor Hollander’s office, our staff is highly trained and sensitive to diabetic patient’s needs. If you feel you are in need of care, please call our office today at (707) 578-1222.

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Pronation Injuries

Running can be a solitary or group activity. Some people run on their own so they can set the pace, while others prefer the social aspect—and motivation—of running in a group. That’s why clubs like the Empire Runners Club in Sonoma County exist. They allow runners of all skill levels to learn from each other and train for local races. Whether you’re an avid runner involved in a club or a beginner exploring the sport, you should be on the look out for pronation injuries which can happen whether you pronate too much or too little.

Pronation is the motion your foot makes when it strikes the ground. It rolls inward slightly, distributing the force of your impact and allowing you push off the front of your foot evenly. It’s a normal and important mechanic for your feet. However, you can either over-pronate or under-pronate which can often lead to injuries.

Overpronation occurs when your foot rolls too far inward, destabilizing the ankle and directing the majority of the shock and force to the big toe and inside of your arch. With overpronation, you don’t push off the ground evenly which can strain your toes. Over time, overpronation may strain your ankles, knees, hips, and back.

Underpronation is not as common, but it can also cause problems. If your foot doesn’t roll inward enough, the force and shock is directed down the outside of your foot. Your push-off is then handled by the smallest toes. This forces them to handle more strain than they should, potentially causing overuse injuries.

Shin splints, tarsal tunnel syndrome, and tendonitis are a few of the pronation injuries that can arise. The key to preventing these types of injuries is by understanding your pronation style and taking steps to accommodate it in your footwear and orthotic choices.

If you’d like to have your gait and pronation analyzed, or are already struggling with overuse injuries, let us know here at John D. Hollander, DPM, in Santa Rosa, CA. You can request more information or an appointment with us by calling (707) 578-1222.

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Back to School Shoe Shopping Guide

For Sonoma County students, the school year is only a few weeks away and at the top of their school shopping list is a new pair of shoes.  You want your child to have quality shoes that follow the latest trends, but you also want to make sure that they will not cause discomfort in the first week of school. Why? Because shoes are expensive and foot pain can distract from studies and having fun.

Take a look at our easy shoe shopping guide to help you search for that perfect new pair of shoes.

  1. Measure their feet. Always measure your child’s feet the day of shoe shopping. Children’s feet will grow on average a ½ to a full size every 4-6 months.
  2. Shop in the afternoon. Don’t head out to the shoe store first thing in the AM. Our feet will swell as the day progresses, so shop during the afternoon where the foot will be the largest.
  3. Quality Materials. Look for a shoe with a leather or mesh upper at minimum. Children’s feet sweat a lot, and this will allow them to breathe. Look for absorbent insoles to take on that extra moisture.
  4. Check out the soles. Look for shoes with a cushioned sole and rubber traction. A thicker sole will act as a shock absorber and make jumping and running more enjoyable.  A rubber sole facilitates in traction and prevents falls.
  5. Avoid twisters. You want the shoe bend at the ball of the foot, but you don’t want it to be so flexible that you can actually twist the shoe.

Other factors to consider when shopping for your child’s school shoes are: purpose (play time, sports, weather), closure options (lace, Velcro, bungy laces- pick what is easiest to put on for your child, but still secure) and socks (wear cotton or poly-blend socks to keep moisture away from the feet).

If possible, consider purchasing two or three pairs of shoes for your child. This will allow for the shoes to be rotated daily and to fully dry out.  Allowing shoes to dry thoroughly will help prevent foot odor. Using a shoe deodorant or sanitizing shoe spray is another beneficial option to preventing foot odor. Also, having shoes for different activities and weather will allow them to last a bit longer while also supporting the foot properly.

Dr. Hollander treats patients of all ages. If you find that your child is having discomfort related to their feet, please give our office a call at (707) 578-1222 to schedule an appointment.  We carry shoe deodorant, fungicidal and sanitizing shoe sprays in our office, all of which you can purchase without an appointment or prescription.

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5 Quick Exercises to Strengthen Lower Legs

Keeping your lower legs strong is important to help you stay upright and moving forward. Having stronger legs allows you to support your upper body. Having stronger ankles means your response to changes in direction will be swift.  And having stronger arches and toes means a better grip on the ground and less opportunity for foot pain.

Quick Calf Exercise: Calf raises are the easiest exercise you can do to strengthen your calves. Not to mention, they can literally be done almost anywhere! Calf raises are done by standing with your feet shoulder width apart.  Start by slowly raising yourself up onto the balls of your feet and then bringing your heels back to the ground. Repeat this movement 15 times.  Next, point your toes inward and repeat the lifting motion. Complete this movement 15 times.  Finally, point your toes outward with your heels together (like a ballerina) and repeat the lifting motion 15 times.

Quick Achilles Exercise: This is more of a stretch, but still very beneficial to the health of your lower legs. Stand 8-10 inches in front of a wall and place your hands flat against the wall.  Step one foot backward, keeping the knee straight. Then, bend the knee of the opposite leg while keeping both heels flat on the floor.  Push your hips forward until the Achilles tendon and calf muscles can be felt stretching.  Hold this stretch for 30 seconds before switching sides. Repeat three times on each side.

Quick Ankle Exercise: If you know your alphabet (and I hope you do) you can complete this exercise with ease.  Sitting in a chair with your feet flat on the ground, raise one foot off the ground, about 3-4 inches. Using your foot, start to draw out the capital letters of the alphabet A-Z.  Repeat motions on the opposite foot.  If you want to do more, you can try spelling the lower-case letters as well.

Quick Arch Exercise: You can strengthen your arches and the underside of your feet with the use of a marble!  While sitting in a chair (or standing) pick up a marble with your toes and put the marble into a container. Repeat exercise with opposite foot.

Quick Toe Exercise: With a towel on the ground, use your toes in a scrunching motion, to pull the towel closer to you.  You can make this exercise more challenging by placing an object on the towel, such as a bottle of water or shoe.

With these 5 quick lower leg exercises, you will be on your way to building stronger bones, increasing your flexibility and having leaner muscle, which means a better functioning metabolism.  Remember to perform new exercises slowly and try not to over do it. Instead, work on building up your repetitions or holding time, little by little.

If you are experiencing Achilles pain, shin splints or foot pain, remember, that foot pain is NOT normal. Call Dr. Hollander today at (707) 578-1222 to address your discomfort and find a solution today!

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