John Hollander, DPM

Sports and Foot Pain in Children

Foot Pain in ChildrenFoot pain in children can be very common, especially when they are active in sports. Spring is here and that means baseball and soccer season. Some sports injuries can be avoided with a little extra care and knowledge. Other conditions just seem to be a part of growing up. Fortunately, your child should grow out of them over time.

One of the most commonly seen causes of foot pain in young people is Sever’s disease. This is when the growth plate in the heel becomes inflamed and swells, which results in pain and discomfort. The most common time for this problem to occur is during their growth spurt at the beginning of adolescence. Most children, by the age of 15, will have grown out of this condition because their feet will have reached their adult size. The fact that the growth plate grows faster than the leg muscles, along with the stress and pressure put on the feet during physical activity, leads to Sever’s disease.

Another common cause of pain in the feet is growing pains. This type of discomfort is typically felt more so at night than in the morning. This pain usually comes and goes and may last for weeks or months, but they will grow out of it. To ease growing pains you could try massaging your child’s legs and feet or help them to stretch the muscles themselves. Heating pads are also a good source of pain relief for your child’s sore muscles. A doctor may prescribe an anti-inflammatory, but always make sure the correct dosage is giving and that your child has no allergies.

For more information about foot pain in children call Dr. John Hollander at (707) 578-1222 to schedule an appointment in our Santa Rosa, CA office. We want your children’s feet to be pain-free so they can enjoy being young and staying active.


Podiatrists Treat Skin Conditions Too!

When we think of a podiatrist, we tend to think of a doctor that treats broken ankles, hangnails, neuroma, and performs foot surgery. But did you know, podiatrists can also treat several dermatology issues related to your feet?

Some of the common dermatology issues treated includes Psoriasis, Dermatitis, Athlete’s Foot, Melanomas, Warts, and Venous Stasis Dermatitis.

Psoriasis
What is it? Psoriasis typically causes a scaly, red rash that can appear almost anywhere on a person’s body, including the feet.

Causes/Symptoms: Psoriasis develops when the body replaces skin cells too fast. There are many different types of psoriasis and two of the most common are Plaque Psoriasis and Palmoplantar Pustulosis.

Plaque psoriasis can occur on almost any part of the body, including the feet. This type of psoriasis causes red, dry patches of skin known as plaques. These plaques are usually covered in silvery scales and can be itchy and sore. In more severe psoriasis, plaques may also crack open and bleed.

Palmoplantar Pustulosis creates many tiny, pus-filled blisters on their feet, hands, or both. Despite their appearance, these blisters are not infectious or contagious. They can cause itching or painful burning sensations.

Treatment: The three primary treatments are topical medications, light therapy, and systemic drugs.

Dermatitis
What is it? Dermatitis is a very common condition resulting in inflammation of the skin.

Causes/Symptoms: Dermatitis can occur when you have contact with a substance that causes an allergic reaction, such as, lotions, adhesives, nickel, poison ivy, and even medications.

Treatment: Treatment includes a prescription for topical steroids or moisturizers. Your doctor will also want to determine the cause for your allergic reaction and eliminate exposure.

Athlete’s Foot (tinea pedis)
What is it? Athlete’s Foot is a fungal infection that usually occurs between the toes but can also affect other areas of the foot.

Causes/Symptoms: Fungus thrives in warm, damp environments, which are commonly found inside your shoe, around pools and showers. Symptoms include dry skin, peeling skin, itching, burning, swelling, and blisters.

Treatment: Treatment includes a prescription for an anti-fungal, as well as, encouragement to keep your feet dry, and to wear proper footwear around pools and in public places like showers.

Melanomas of the Foot
What is it?  Melanoma is a cancer that begins in the cells of the skin that produce pigmentation (coloration).  It can occur on your skin but also be present in your fingernail or toenail bed.

Causes/Symptoms: Most cases are caused by too much exposure to ultraviolet rays from the sun or tanning beds, but can also come from exposure to radiation.

Signs to look for on your skinABCDs of melanoma:

Asymmetry- one half of the spot is different in shape than the other half.
Border- the border is irregular. The edge/ border is typically ragged, notched, or blurred
Color- Mix of colors or hues are present. It is not uniform in color.
Diameter- Melanoma grows, whereas moles will remain small. A spot larger than a pencil eraser is cause for concern.

Signs to look for on your nail bed:
A pigmented band, the length of your nail, that does not grow out with your nail. Over time it can become wider, the color can change throughout the band, development of a nodule can occur, or may even cause the nail to crack.

Treatment: Treatment begins with examining the area of concern and then taking a biopsy. If biopsy determines the area to be cancerous, your podiatrist will recommend the best course of treatment.

Warts
What is it? Warts are a viral infection caused by the human papilloma virus (HPV). They are often mistaken as corns or calluses. They occur when HPV enters the skin through a small cut or abrasion. Children and teenagers are more susceptible to getting warts than adults.

Causes/Symptoms: Warts are spread by touching, scratching, or contact with skin shed from another wart. If left untreated, wart clusters can form.  Warts look like small rough growths on your skin.
Treatment: If self-care approaches have not helped, your podiatrist can provide you with a few options: prescription-strength salicylic acid, Cryotherapy, minor surgery, or laser treatment.

Venous Stasis Dermatitis
What is it? Venous Stasis is when the veins in the leg are no longer properly carrying blood back to the heart. This also results in blood building up in the feet, ankles, and legs. 

Causes/Symptoms: Venous Stasis is when the veins in the leg are no longer properly carrying blood back to the heart. This also results in blood building up in the feet, ankles, and legs. The pigmentation from the red blood cells stains the skin from the inside, and a reddish-brown discoloration develops on the skin, which is called Venous Stasis Dermatitis (VSD).

Early symptoms of VSD include:
-heaviness or aching when you stand or walk for extended periods of time
-swelling at the ankle at the end of the day
-varicose veins
-skin is itchy, dry, red, or sore

Symptoms as VSD progresses include:
-swelling beyond the ankle
-dry cracked skin
-red to violet-colored open sores
-shiny skin

Treatment: Types of treatment include:
-compression socks
-mechanical compression to help move fluid away from the leg
-corticosteroid creams
-vein surgery to repair damaged veins (such as placement of a stint)

If you think you are experiencing a dermatological issue related to your feet, you don’t necessarily have to find a dermatologist. Your established podiatrist may be able to treat your condition.  Call Dr. Hollander today if you think you may have a skin issue that is causing you discomfort or concern at (707)578-1222.

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Tips for Keeping Your Feet Warm

As I’m sitting at my desk next to a window, I notice that my feet are starting to get quite cold!  This got me thinking, that others, maybe you, are experiencing cold feet right now too!?  What can be done to resolve the uncomfortable feeling of cold feet?  Well, here are a few suggestions I can recommend:

  1. Get moving. Blood circulation instantly warms the body up.   That’s why we get warmer after a workout, all the blood moving around our body. So try walking up and down your hallway a few times.
  2. Stretches. If you’re sitting at a desk like me, then try performing foot stretches.  Move your ankles in circular motions ten times in one direction, and then repeat ten times in the opposite direction.  You can also flex and relax your feet too!
  3. Socks. If you don’t have any on right now, then please, do so.  But when selecting what type of fiber to wear, some are more effective at keeping the cold away, then others.  Moreno wool would be my first choice for it has the ability to hold more moisture and keep it off your feet.  Moisture is was makes your feet feel cold.  Bamboo can be a great option if you find wool too itchy.  It is also eco-friendly!
  4. Slippers. Yes, not only will they keep your feet warm, they can protect your feet from bumps and cuts.  If you have a pair with orthotic support- even better.  If your slippers hurt your feet, call your podiatrist to talk about orthotic inserts.  Slippers should be supportive too!
  5. Shoes. While we encourage wearing shoes that allow airflow to help prevent foot fungus, it is counterproductive when it comes to warming your feet.  Wearing boots or shoes designed to minimize breathing will help keep air and moisture from touching your feet, thus keeping them warmer.
  6. Footbaths. A nice warm foot soak is an excellent way to warm your toes back up. But be sure to check the temperature with your hand or forearm, especially if you have neuropathy. We don’t want you to burn your feet!
  7. Floor mats. This idea may be overlooked, but worth a try.  If you have solid floors where your desk or chairs are, you could try adding a floor mat in that space.  This will create a barrier between you and the floor.  They even have heated floor mats on the market, if you want even more warmth.

I hope after following these tips you will find relief in your cold feet.  If cold feet just seem to be following you everywhere, then give Dr. Hollander a call.  There may be something else going on.  You can schedule a consultation by calling (707) 578-1222.

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When a Small Trip Can Turn into a Dangerous Fall

Whoops!  You tripped on that floor mat, again!  And this time you almost fell on the floor.  Falls are not just a ‘normal part of getting older’.  And while yes, as we age our chances for falling do increase, it doesn’t mean it has to happen! In fact, falls are caused by a number of risk factors for people of any age.  So what are the risks associated with trips and falls and what can be done to prevent them?

Types of Risk Factors For Falls

If you experience any, or a combination, of the following you could be at an increased risk for trips or falls:

  • weak muscles, especially in the legs
  • poor balance, causing unsteadiness on your feet
  • foot problemsincluding pain, gait, and deformities
  • vision and hearing problems
  • dizziness or lightheadedness
  • taking medication that makes you dizzy or drowsy
  • Vitamin D deficiency

Weak muscles

Our muscles gradually get weaker as we get older, affecting our strength and balance and making it more difficult to undertake daily activities.  As well as normal changes caused by ageing, there are a number of reasons why our muscles get weaker, including:

  • lack of physical activity and exercise
  • conditions like arthritis

Poor balance

A number of things can cause poor balance, including:

Do exercises that make your legs stronger and improve your balance. Tai Chi is a good example of this kind of exercise.

Foot problems

There are many conditions that can cause discomfort to the feet, which in turn can lead to an increased risk in falls.

Problems such as:

  • corns, calluses bunions,ingrown or thick nails and foot ulcers
  • Improper gait– over pronation or under pronation
  • Poorly fitted footwear; you wouldn’t want to wear flip flops to a construction site
  • Numbness in the feet such as neuropathy, sometimes linked to diabetes, can leave you unable to fully sense where your foot is on the floor, also leading to an increased risk of a fall

Scheduling a visit with your podiatrist can help address your foot problems and assist in eliminating the risk factor for falls.

Vision and hearing problems

Problems with your vision and hearing can make it more difficult to move around safely.

Eye problems can make it difficult to anticipate and spot slip or trip hazards in your home.  As we get older, changes to our depth perception and ability to adjust to changes in lighting can also contribute to the risk of falls.  If you wear bifocal or varifocal lenses in your glasses, you might sometimes find it difficult going down steps, stairs and curbs. If you wear bifocals, you may want to have a pair of distant only glasses for your outdoor activities.  Cataracts, glaucoma and vision-related problems linked to stroke or dementia can also increase your risk of falling.

We are finding more correlations in falls and loss of hearing from studies in the last 5-8 years.  Studies have found that when we lose our hearing, our brain is having to overwork with limited resources. So while you should get your eyes checked regularly, you should also have your ears checked too.

Dizziness or lightheadedness

There are a number of reasons why someone might be dizzy or lightheaded. It’s not normally a sign of anything serious, but should be checked out by a doctor.

Understanding why you become dizzy is important to counter the risk of falling. Some of the most common causes include:

  • a drop in blood pressure when getting up from lying or sitting
  • inner ear problemssuch as inner ear infections and wax blockages
  • problems with your heart rate or rhythm
  • dehydration

Medication

The side effects of some medicinessuch as dizziness, lightheadedness, unsteadiness, drowsiness, blurred or double vision, and difficulty thinking clearly, and taking more than 4 medicines at the same time, can increase your chance of falling.

Medications that most commonly cause these symptoms include:

  • psychotropics (tablets to treat low mood)
  • blood pressure-lowering medications
  • sleeping tablets and sedatives
  • anticonvulsants (medication for epilepsy)
  • over the counter medications

Side effects can vary from person to person depending on their age, weight, gender, ethnicity and general health, so it’s important that you know and understand how your medications can affect you to prevent falls from occurring.

Vitamin D Deficiency

Vitamin D improves muscle function and strength. The weaker your muscles, the more likely a fall is to occur.  Vitamin D can be obtained from a supplement or foods such as fish, red meat, eggs, and fortified foods like cereal.

Trips and falls can be caused by so many different factors.  By taking your specific situation into consideration and taking note of the fall risk factors that relate to you, falling can be preventable.  If you have noticed an increase in tripping or falling, contact your doctor, which also includes your podiatrist, to discuss your concerns.

We are here for you at Dr. Hollander, DPM to help you at any time, one step at a time.  Call today to speak with our friendly staff members at (707) 578-1222.

If you are in need of more information on fall prevention, the CDC has several helpful brochures you can download at any time for free.

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Owie! Is That An Ingrown Toenail?

An ingrown toenail is when the nail curves inward and grows into the skin, usually on the edges. This painful piercing of the nail irritates the skin and causes redness, swelling, and warmth, all of which are signs of an infection. Bacteria may even enter the area further infecting it.  This is often shown by the sign of white, yellow, or green puss.

 

There are a variety of causes for ingrown toenails, such as:

  • Trauma or injury of the nail
  • Improper nail trimming
  • Improper shoe fitting
  • Heredity
  • Fungal Infections

Some ways to avoid ingrown toenails are practicing proper trimming techniques of the toenails and wearing well-fitted shoes and socks.

If your ingrown toenail has become infected you shouldn’t attempt to treat it yourself, avoid “Bathroom Surgery”. Instead, go and see your friendly foot doctor.

We love treating ingrown toenails and pride ourselves in providing a pleasant experience in our office. Give us a call today if you think you may have an ingrown toenail (707) 578-1222.

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Trench Foot

The mission is set.  There are 11 days to complete the grueling course of hiking mud bogged trails, swimming in frigid waters, running in complete darkness, scaling down waterfalls,  and more.  The goal is to be the first team to reach the finish line.  Sounds easy enough right?  This is describing the newly released show of The World’s Toughest Race, which can be viewed on Amazon Prime.  One of the biggest challenges to this race that many competitors faced was the result of trench foot.

You see, this course takes place on the island of Fiji.  Beautiful, yes, but this course has your feet exposed to cold weather and spending hours upon hours submerged in water.  There are specific gear on the market designed to help keep your feet dry, but they aren’t perfect, and if you didn’t pack enough dry socks for this race, your feet are in for a rude awakening.

Many of the contestants on the race suffered from varying degrees of trench foot.  Trench foot (or immersion foot) occurs when the foot is unable to dry and is constantly subjected to moisture and cold temperatures.

Think of how your fingers and toes get pruney after a long shower or bath.  Trench foot looks a little like that in the beginning stages, but as it progresses the condition worsens.  The skin on your feet begins to peel off, exposing the sensitive under layer of tissue.  You can experience a tingling or itching sensation, pain, swelling, cold blotches, numbness or have a heavy foot feeling.    If left untreated, it can cause permanent damage to the nerves, muscles, skin, blood vessels, and the development of gangrene is possible along with amputation.

There are quite a few scenes in the show where contestants are examining their feet and you can see the onset of trench foot.  Some contestants even had to be airlifted out of the race because their feet were so painfully bad.

While the immediate effects of trench foot can be alleviated, the condition can lead to long-term tissue damage and chronic pain. A person with trench foot may require long-term follow-up care.  The first step to treating trench foot is to remove the person from the cold wet conditions.  Warming up the feet need to be done slowly.  If the feet are warmed up too quickly, it could cause damage.  Your doctor may prescribe a pain killer depending upon the severity of your condition.  Additional treatment steps include: cleaning and drying the feet, wearing clean socks daily, sleeping with bare feet, elevating feet, and limiting walking and taking an anti-inflammatory.

While completing the race in as few days as possible is certainly a tactic in helping to prevent trench foot, this race is rather grueling, so there are other measures racers should consider to prevent trench foot.

  1. Wear thick wool socks for warmth
  2. Change socks 2 or more times a day and massage your feet
  3. Clean feet and allow to dry completely
  4. Limit water exposure whenever possible
  5. Never sleep in wet socks or shoes
  6. Attend to tingling sensations immediately
  7. Use an antiperspirant or foot powder for your feet
  8. Stay hydrated!

The take away from this race, in regards to preparation and care, is to keep your feet as dry as possible.  The taxing race already puts a lot of strain on your feet, with hours upon hours of hiking and running on top of miles of swimming, rafting, and paddleboarding.  Taking every opportunity to keep your feet dry and prevent them from getting wet is a necessity in preventing the dreaded trench foot.

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Gout Tips- Prevention and Management

Gout is a form of inflammatory arthritis that causes pain and swelling of the big toe; and sometimes the ankle or knee.

Gout occurs when there is a high level of uric acid in the blood which causes needle-like crystals to form around a joint.  These crystals are what causes the pain. “Uric acid is produced when the body breaks down a chemical called purine. Purine occurs naturally in your body but it’s also found in certain foods.  Uric acid is eliminated from the body in urine.

It can be managed with medication and maintaining a balanced healthy diet.  Follow these tips to help manage and prevent another gout occurrence.

Foods to avoid:

-Organ and glandular meats such as, liver, kidney and sweetbreads, which are very high in uric acid.

-Select seafood that contain higher amounts of purine, such as, anchovies, sardines, mussels, trout, and tuna.

-Alcohol. The metabolism of alcohol is thought to raise uric acid production.

-Saturated fats

-Sugary foods & refined carbohydrates

Foods to limit:

-Oatmeal, wheat bran, and wheat germ

-Select Vegetables: asparagus, cauliflower, spinach, mushrooms, and green peas

-Select proteins: poultry, fish, beans

-Meat soups and broths

Foods to use as desired:

-Coffee. It may help reduce your gout risk, so enjoy as much as you’d like.

-Vegetables.

-Fruits, especially Cherries, are shown to reduce gout attacks.

-Vegetable soups and stocks

-Weight loss. A lower calorie diet is always beneficial and the reduction in weight is good for your joints.

-Complex carbohydrates- whole wheat & whole-grain breads and cereal and rice.

-Water

-Low-fat dairy, shown to aid in the excretion of uric acid.

-Nuts & peanut butter

-Soda and tea

For a list of purine levels in the foods you enjoy, click here.

To help you navigate your gout diet, visit our Pinterest page for a few gout friendly recipes.

 

What to do when you have a Gout Flare-up?

  • Take medication that you have on hand– “Start treatment immediately with over-the-counter ibuprofen (MotrinAdvil) or naproxen (Aleve), but never take aspirin, which can worsen a flare. If you have had a flare before and your doctor has prescribed an anti-inflammatory medication to take in the event of another, take your prescribed medication as your doctor directed. If you are already taking a uric acid-lowering drug to reduce the risk of flares, continue to take that drug.”
  • Ice the areaApplying an ice pack to the painful joint may help ease pain and inflammation. Wrap a pack (a bag of crushed ice or frozen peas will also do) in a dish cloth and apply to the area for 20- to 30-minutes at a stretch several times a day.
  • Hydrate– Drink plenty of fluids. Aim for around 16 cups of water a day.
  • Elevate Your Foot– raising your foot about your heart could help reduce swelling.
  • Relax– Reduce your stress as much as possible.  Stress can aggravate gout.

 

If you are experiencing the symptoms of gout, or have a painful toe, call Dr. Hollander for an evaluation. You don’t need to be uncomfortable anymore! (707) 578-1222.

 

Sarah D.B.

 

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How To Survive a Broken Ankle

You never see it coming. That moment when you take a step and land on your foot wrong. Your ankle and foot start to swell up immediately followed by pain.  Your visit to the doctor confirms it’s a broken ankle. Now what? How are you going to survive a whole month, or more, with only the use of one leg? Not to worry. I have compiled a list of things you can do to survive a broken ankle.

First things first, tell everyone. Let your family and friends know that you have become temporarily immobile. Heck, you can even have fun with the story of how you broke your ankle. I like to joke that I lost to a tree when I tripped.

Accept all the help. I know, it can be hard to accept help when you’re so used to being independent,  but now is the time to move past the ego and say YES. Happily accept all the meal offers, house cleaning, laundry, babysitting, ice pack changes, you name it! And even better, tell them exactly what you need!

Surround yourself with activities to keep your mind busy. While you’d probably want to get up and down all the time, it is best to stay put and keep your foot up as much as possible. Consider making a new list of shows to binge-watch. Utilize the zen coloring book you got for your birthday. Catch up on your pile of reading books. Try a new craft like cross-stitching or miniature watercolor painting.

Research mobility aids. You will quickly find out that crutches stink. If you can afford a walking scooter or an iWalk2.0, get one. They will make life with a broken ankle, so much easier. Sometimes insurance will cover them, if not, the used marketplace can be an affordable option.

If you wish to stick with crutches find something soft and cushy to cover the armrests and save your armpits from bruising and rashes. Another note about crutches, make sure they are tailored right for your height and arm length. You do not want to be bending forward. Here is a video on how you should fit and use your crutches.  https://youtu.be/Za2-OVjaTPc  (Always consult with your care team before using a walking device different from the ones that were originally provided to you).

Get creative.   Find a basket or bucket with a loose handle. You can put items in it like your snack or drink, and hold onto the handle while you walk in your crutches. Use an elastic headband to help keep your ice pack around your foot. Don’t use a headband that is tight.

Embrace the downtime. Chances are your life is go, go, go. Look at this time as a chance to slow down and focus on YOU!  This is especially important if you’re a parent.  Enjoy not feeling guilty about taking a nap, chatting on the phone with your best bud, and not cleaning the house.

Socialize with others. Whether you’re a hermit or a social butterfly, making time to socialize will make this recovery time go by much faster.  Invite friends over and order pizza. It can’t get any easier than that!

Invest in comfort items. Buy pillows that will allow you to rest your leg comfortably during the day and at bedtime. Use a swivel table or tv tray stand to keep necessities within arm’s reach. Purchase a shower chair and scrub brush with a long handle.  Buy cute and comfortable sweatpants with pockets. You can be practical and fashionable while you heal.

Buy quality, flexible, icepacks.  The more flexible and longer the icepack, the better icing coverage your foot can get.

Having a broken ankle isn’t fun, but with these tips, you can certainly make the most of the time by being comfortable and focusing on your healing.

Always consult with your healthcare provider before using any type of walking device.  If your pain worsens or does not improve, notify your doctor. 

If you have endured an injury to your ankle, seek medical care.  Dr. John D. Hollander is here to help you recover! Call today to schedule your appointment at 707-578-1222.

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How to Fix Smelly Feet

You might enjoy taking off your shoes and kicking back in Bodega Bay, but if you suffer from foot odor, others around you might not like it as much. Taking care of smelly feet doesn’t have to be difficult or overwhelming. It is a fairly simple thing to do that just requires a little extra care.

Your feet tend to sweat more than any other part of your body. When you mix this excess perspiration and a confined, moist environment (like your shoes), the combination can be quite stinky. People who are on their feet all day or wear the same shoes without giving them time to air out are more likely to suffer from this condition, also known as bromodosis. For extreme odor problems, it’s important to make sure that a fungal infection or athlete’s foot isn’t the cause of your smelly feet.

To prevent foot odor there are a few things you should keep in mind. Shoes take about 24 hours to completely dry out, so don’t wear the same pair two days in a row. Even a little bit of excess moisture can cause an unpleasant smell. To help keep your feet dry you can use an antibacterial foot powder or an antiperspirant. Also, always remember to wear socks. Specifically, wear a pair made of synthetic material that wick away moisture from your skin. If your feet already smell, there are different soaps that can get rid of the odor in a few days.  If you would like help selecting the right over-the-counter product, we do carry many in our office that are available for purchase and we would be more than happy to help you.

Call Dr. John Hollander at 707-578-1222 to schedule an appointment in our Santa Rosa, CA office. Don’t let smelly feet leave you feeling uncomfortable or embarrassed. Call us today and we will help you get rid of your foot odor once and for all!

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