John Hollander, DPM

Hello Hiking, Bye-bye Neuroma Pain

Hiking in Santa Rosa, CA can be a thrilling and rewarding experience. From the beautiful vistas of Sugarloaf Ridge State Park to the old-growth redwoods in Armstrong Woods and to the wide open spaces, we have it all. If you experience neuroma pain it can keep you from enjoying the great outdoors. If your toes are hurting, now is the time to get healthy and address the pain!

A neuroma is a condition in which the nerves between the metatarsal bones become inflamed. You can often feel a thickening at the base of your toes, and the area may be painful or feel as though it is burning, making it difficult to walk. It is believed that wearing shoes that are restrictive or too tight can contribute to the formation of a neuroma. The pain is usually made worse when more pressure is put on the area, so wearing high heels that force your weight onto the ball of your foot is not recommended.

Treatment for a neuroma is usually conservative and non-invasive. Sometimes a simple change in footwear is all that is needed. Make sure your shoes have plenty of wiggle room for your toes, and that they offer adequate support. Additionally, you can add a shoe insert or a custom-made orthotic to ease your pain. You can also try calf stretches, which can relieve some of the pressure on your foot. If these treatment methods do not work for you, you can go on to more invasive measures. This might include steroid injections or cryotherapy. As a last resort, surgery may be a viable option.

We know how frustrating it can be to suffer from neuroma pain. You may feel unable to enjoy your life to the fullest because of the discomfort. Call today so we can get you back on the path to foot wellness, and then out on those hiking trails. Call Dr. John Hollander at (707) 578-1222 to schedule an appointment in our Santa Rosa, CA office.

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Can Nail Polish Actually Prevent Toenail Fungus?

Toenail fungus, once you get it, it takes time to treat! So how can we prevent it from occurring in the first place?  Well, there are a few things we can do to stave off that yucky fungus.

  1. Keep your feet clean and dry
  2. Avoid walking barefoot in public places like gyms and pools
  3. Wear breathable footwear
  4. Never wear another person’s footwear!

In addition to these fungal prevention tactics, you can also add an extra punch of prevention by using an enriched nail polish*.  A great brand to try is Dr.’s REMEDY, which was formulated by actual podiatrists!

Dr.’s REMEDY nail polish contains ingredients like garlic bulb oil and tee tree oil that are naturally good at staving off fungus due to their anti-fungal and anti-bacterial properties.  It also contains Vitamin B and C, Biotin and Wheat Protein which are all good for nail health and strength!

If you’ve found yourself with a bought of toenail fungus that is not resolving on its own or with over the counter medications, call our Santa Rosa office today to learn more about anti-fungal laser treatment. Our office number is (707) 578-1222.

 

*Dr.’s REMEDY nail polishes are a cosmetic. Dr.’s REMEDY is not FDA approved and cannot make claims to cure fungus.

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Why Does My Toe Bend That Way?!

Do you have a toe or toes that look bent out of shape, but you don’t recall any trauma happening to them? You could have a case of Hammer Toe, Claw Toe or Mallet Toe!  Not to worry, they are not dangerous conditions to have, but they can be quite uncomfortable and most importantly- treatable and preventable!

While Hammer Toe, Claw Toe and Mallet Toe all look similar, it is a matter of which joint(s) in the toe that is bending, that classifies which condition you have.

A Hammer toe occurs when the proximal interphalangeal joint (PIP or middle joint) of the toe is bent abnormally.

A Claw toe occurs when both the middle joint (proximal interphalangeal/ PIP) and the first joint (distal interphalangeal joint/ DIP) is bent.

A Mallet toe occurs when only the first joint, known as distal interphalangeal, is bent.

Other symptoms include redness, swelling, calluses, corns and ulcers at the joint.

CAUSES

 

Causes for these conditions are often due to an imbalance in the muscles surrounding the joint.  When one of the muscles around the toe weakens, it loses its ability to bend or straighten out. Muscles can weaken for a few reasons:

– Poorly fitting shoes, that cause the toe to bend while wearing them (e.g. high heels or shoes that are too small)

– A broken toe that does not receive treatment and heals abnormally

– Nerve damage caused by diabetes

–  Arthritis

TREATMENT & PREVENTION

As with many foot related conditions, the sooner you address a hammer, claw or mallet toe, the easier it is to treat!  If the condition is relatively new, your podiatrist may instruct you to perform special foot exercises and stretches that are designed to strengthen your toe muscles.  They may also prescribe a special shoe insert or recommend special corn pads or foot straps to help relieve your pain.  In cases with high pain, your podiatrist may give you a cortisone injection.  If the condition is left untreated for too long, you may have to have surgery in order to repair the toe.

You can prevent an onset of hammer toe, claw toe or mallet toe by wearing shoes that provide ample wiggle room for your toes and arch support and, performing exercises that encourage your toes to stretch, wiggle and bend freely.

If you have noticed that one or more of your toes are bending in an abnormal manner, schedule an appointment with Dr. Hollander right away! He can provide you with the best method to treating your bent toe and getting it back into shape! Call today at (707) 578-1222 for questions and appointments.

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How To Tell a Foot Sprain From a Fracture!

If you’re like me, you probably jump at every opportunity to get out side and play. Whether that mean going for a walk at Sugar Loaf, playing a game of bocce ball in the yard or volleyball at the beach, just about any outdoor activity can sometimes lead to an injured foot or ankle, if we aren’t careful! So if you happen to injure your foot or ankle, how can you tell if it’s a sprain or fracture?

A sprain is trauma to the ligaments. It can range in severity and may involve damage to the surrounding tissues. You may find that you have bruising, pain, swelling and inflammation. To treat a sprain, you must rest your feet by following the RICE method: rest, ice, compression, and elevation. Discontinue the activity that caused the sprain while your foot heals. You may find that physical therapy or MLS Laser Therapy can help get you back to full strength.

A fracture is an injury to the bones. A bone can be broken in one place or in multiple areas. When a bone breaks, it can cause damage to surrounding parts of the foot including the ligaments and the joints. You will feel immediate pain, and there might be swelling, bruising and redness. In most cases where there is a fracture, you will not be able to put any weight on the foot because of the pain and instability. Any time you suspect a broken bone, come in and see us as soon as possible so that treatment can occur. Your bone may need to be set back into its correct position, and you will have to immobilize the area (by way of a cast or splint) until it heals.

For more information on treating a foot sprain or a break, call Dr. John Hollander at 707-578-1222 to schedule an appointment. You want any injury—to you or your child—to be treated quickly and so it will heal well and avoid future complications, so please, do not hesitate to give us a call.

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How to Finally Get Rid of a Plantar Wart!

How to deal with Plantar WartsYou’ve tried the old duct tape method and over the counter wart remover products, and yet that pesky wart is still there causing discomfort to your feet. So, what can you do? When at home remedies fail then it is time to visit a podiatrist. Podiatrists have access to more aggressive solutions and methods to get rid of your pesky plantar wart.

First and foremost, prevent your warts from spreading by keeping them covered with a bandage until you begin treatment. And remember, do not touch them and always use good hygiene practices.

The first line of defense a podiatrist will use in treating your plantar wart is either a stronger salicylic acid medicine or a freezing medicine.

Salicylic Acid: Similar to the products you purchase at the store, but at a prescription strength. The Salicylic Acid is designed to remove layers of the skin a little at a time. This topical method is applied on a regular basis until the wart is gone.
Cryotherapy: If your podiatrist suggests freezing your wart, also known as cryotherapy, this procedure will be done during your office visit. Cryotherapy is the method of applying a liquid nitrogen to the wart. The chemical reaction causes a blister to form around the wart, which will later slough off. This method can be painful, so often the doctor will apply a numbing solution prior to the procedure.

If your plantar wart does not respond to salicylic acid or cryotherapy, the next step would be to consider other wart removing alternatives.

Alternative Acids: When your wart doesn’t respond to salicylic acid, your doctor will scrap off the surface of the wart and apply trichloroacetic acid with a wooden toothpick. This method will require a few visits back to the office for each application.
Laser Treatment: A laser is used to cauterize tiny blood vessels inside the wart. This will then cause the wart to die. This method can also be helpful if a patient is unable to comply with regular applications of other medications.
Immune Therapy: A combination of medications or solutions are used to stimulate your immune system so that it can fight off the viral warts. Surgical Removal: This method is often used as a last resort due to the possibility of leaving a scar.  The wart tissue is either cut off with a scalpel or a needle carrying an electrical current will be inserted into the wart killing it.

Your feet are vital to everything you do, so take time to inspect them daily—including the soles. This condition is common in children, so parents should look at their children’s feet often. Those with compromised immune systems may also be more susceptible to this common condition.

Whether you have one or a cluster, we’re here to help you put the spring back in your step. For more information on plantar wart treatments, call Dr. John Hollander today at (707) 578-1222. You can also schedule an appointment at our Santa Rosa, CA office by requesting an appointment online. We want your feet to stay wart free so that you can feel confident and comfortable, so go ahead and put away your duct tape and give us a call!

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How To Stay In The Race When You Have Heel Pain- Extracorporeal Shockwave Therapy

Are you preparing for the upcoming Annadel Half Marathon in Santa Rosa, California next month? Wouldn’t it be devastating to have a chronic condition like plantar fasciitis or have an Achilles tendinitis flare up right before the big event?! If the unthinkable happens, extracorporeal shockwave therapy might be necessary to promote healing to your feet so that you can still run the day of the race.

Extracorporeal shockwave therapy, or ECSWT for short, is a therapy in which shockwaves are sent directly to the site of pain. It’s used when other more conservative treatments have failed, but before opting for surgical methods. There are different levels of shockwaves; some that require a local anesthetic and others that don’t. This therapy offers many of the same results as surgery, but with less down time and a much faster rate of recovery.

Podiatrists and patients alike prefer ECSWT to surgery, because of reduced healing times. You will probably notice, even after the first day of treatment, that the pain does not worsen. As the damaged cells begin to repair and new cells grow, you will notice that your pain is subsiding even more. After a session of this therapy, you will most likely notice soreness or possibly some bruising at the site of treatment. However, these effects are mild compared to those of a surgical intervention.

If you want to learn more about ECSWT, call Dr. John Hollander, DPM today at 707-578-1222 or schedule an appointment online. We want your feet to be as healthy as they can be. Faster, more effective healing means you’ll be ready for your next big race.

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Spring into Support With Orthotics for your Sandals

Spring has finally arrived! As the weather begins to get hotter, spring sandals become the shoes of choice. This year’s trends are varied. You might try an oil-rubbed leather, or maybe you prefer color blocking and wide straps. Whatever your favorite sandal style, comfort is key.

Custom Orthotics

If you wear orthotics in your shoes, you might feel like your footwear choices are restricted. There’s good news–most orthotics can be customized to fit any pair of shoes. Custom orthotics are made specifically for your feet from molds taken in our office. The materials used to construct these devices vary depending on your needs. However, the results are the same—feet that are free of pain.

Keep in mind that orthotics for sandals and dress shoes are smaller and regulate your foot less than those you use in your running shoes. A foot bed that can be removed is a must for orthotic use in sandals. Remember that heel height also impacts the effectiveness of these inserts—as heel height goes up, helpfulness decreases. Bring in your favorite pair of sandals or dress shoes, and our expert staff will explain your options.

Orthotics are used for many different conditions. The functional type control range of motion, while the accommodative type offer more support or cushioning. Both are used to control pain and address poor foot mechanics at the same time. Orthotics are commonly used to treat foot conditions including plantar fasciitis, tendinitis, and bunions. Custom-made orthotics are a good investment toward avoiding long-term complications brought on by a foot condition.

Remember, only a podiatrist will be able to tell you which kind of orthotic will best treat your condition.  Call Dr. John Hollander at (707) 578-1222 to schedule an appointment at our Santa Rosa, CA office. Let us help you get the right orthotics for your feet. Also, let us pamper your spring feet with a medical pedicure, because when your feet are cared for, you feel rejuvenated.

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What to look for in a walking shoe

Are you in search of a new pair of walking shoes, but you just aren’t sure what features to look for?  With a plethora of options, shopping for a new pair of shoes can be overwhelming.  To help you find the right walking shoe for your feet, we’ve put together a guide to assist you in your search.

  • Wear the same socks you will wear when walking and use them to when trying on your shoes.
  • Shop for shoes later in the day or after you’ve been walking for a while. Our feet tend to swell at the end of the day and that can affect how a shoe may fit.
  • Measure your feet (length and width) before trying on shoes- as we age our feet sizes can change. Stand while your foot is measured to get the most accurate measurement. Ask the salesperson to help measure your feet or, you can measure them yourself.
  • If one foot is larger than the other, try on a pair that fits your larger foot.
  • Try on both shoes at the same time and check the fit by wiggling your toes. If you don’t have at least a half-inch between your longest toe and the end of the shoe — approximately the width of your finger — try on a larger size.
  • Check the width of your shoe. The side-to-side fit of the shoe should be snug, not tight. If you’re a woman with wide feet, consider trying on a men’s shoe, which are cut a bit larger through the heel and the ball of the foot. If you feel like the shoe is too tight, move on to another shoe. Don’t expect it to get wider over time as you wear the shoe.
  • Walk in the shoes before buying them. They should feel comfortable right away. Make sure your heel fits snugly in each shoe and doesn’t slip as you walk. If the heel is a bit loose, there is a shoelace technique you can try before ruling out a pair of shoes. See photos below.
  • Look for a shoe with cushioning in the ball and heel of the foot. The more cushion a shoe has the more comfortable your feet will be as you walk.
  • Select a shoe that has ventilation points or made of a mesh material to allow for air to circulate around your feet and keep them cool.
  • If possible, buy shoes at an athletic shoe store with professional fitters or at a store where you have several options.  We like to send our patients to Fleet Feet in Santa Rosa because we know they have had the proper training needed to get you fitted in the right shoe.

    If your heels are slipping out of your shoes, try the butterfly lacing technique.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Remember, there is no one walking shoe for all. They each have a unique set of features, designs and pricing.  Take the time to try on different brands and sizes and really pay attention to how your feet feel in that pair of shoes. If something feels off, move on to another pair.  If you feel like you aren’t getting enough arch support in your shoes, call Dr. Hollander today to see if you are a candidate for orthotics.

We hope you find this guide helpful in your search for an awesome pair of walking shoes.  If you have any questions, please do not hesitate to give us a call. (707) 578-1222.

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How to Prevent and Treat an Ingrown Toenail

California is known for our never-ending summers, but an unsightly and painful ingrown toenail can put a damper your plans. While it is only March, summer will be here before you know it.   This common foot condition is easy to prevent and easy to treat, so you can stop wasting your time in pain and get back to enjoying your life!

An ingrown toenail occurs when the nail grows into the skin instead of upward. You will notice pain, redness, and swelling. It can even result in an infection if not taken care of right away.

You can usually treat an ingrown toenail at home by soaking it in warm, clean water and gently pushing back the skin where the nail has pierced through.

To prevent a nail from growing into the skin, make sure you trim them straight across, and wear shoes that give your toes plenty of wiggle room.

In certain cases, a podiatrist’s attention will be needed. One of the ways a foot specialist can help is by lifting the nail so that it grows the right way. In other cases, you may need to have your nail partially or fully removed, and some of the surrounding tissue may need to be detached as well. If you see signs of puss in the area, it could be a sign of infection and you might need a course of antibiotics to treat it.

If you are suffering from a painful ingrown toenail, call Dr. John Hollander today at (707) 578-1222 to schedule an appointment in our Santa Rosa, CA office. We can help get your feet back to feeling good and ready for your next outdoor adventure!

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A Caregiver’s Guide to Caring for Feet

While you do your best to care for your clients and improve the quality of their lives, sometimes there are areas of care which may be overlooked.  Among all the tasks that can be required of a caregiver an important one is keeping your client’s feet happy and healthy. Caring for your client’s feet is more than just washing and dressing them daily.  There are other aspects you need to be aware of while providing excellent care to their feet which includes: how to wash their feet, how to trim their nails properly, how to recognize signs of infection and how to recognize signs of discomfort.  Below you will find helpful tips on ways that you can provide excellent care to your client’s feet.

How to Properly Clean Your Client’s Feet

Wash their feet daily with warm soap and water. If your client has dry skin, try adding baby oil or mineral oil to their bath water.  You can also use non-scented moisturizers if your client’s skin is dry.  Be sure to thoroughly dry their feet especially between their toes. If moisture is left behind it can create a breeding ground for fungus.

How to Correctly Trim Your Client’s Toenails

Along with keeping their feet clean, maintaining toenails is also very important! Depending upon which state you live in some caregivers are not allowed to trim their client’s nails.  If you live in a state that allows you to trim nails, be sure to trim the nail straight across. Trimming the nail at an angle or around the nail bed can encourage the nail to grow down and inward, often resulting in a painful ingrown toenail.  If you ever feel overwhelmed by your patients nails, take them to a podiatrist. They have special tools to combat thick and overgrown nails.

If you live in a state where caregivers are not allowed to trim a client’s nails, you will then need to have them visit a podiatrist or a nail salon regularly.  In California, if your patient is elderly and has vascular disease (which diminishes blood flow), neuropathy (lack of feeling in their feet), or diabetes, their insurance should allow them to be seen on a regular basis with a podiatrist to have their nails trimmed and their calluses debrided.  It is especially important for a client with diabetes and neuropathy to have regular visits with a podiatrist because sometimes under the callus build-up there can be an open sore. An untreated open sore can lead to pain, discomfort and even amputation or death! So keep a close eye on them!  If your client’s nails are too thick for them to trim on their own, they can become overgrown and penetrate the skin, leading to pain and infection.

All podiatry offices offer services called ‘palliative foot care’ to patients who do not qualify for regular podiatry care, according to their insurance rules. With palliative foot care the patient/client can pay cash to have their nails cut and their calluses debrided in order to keep their feet healthy. Remember, when their feet are healthy, they can then keep the rest of their body healthy.

How to Identify Undesirable Foot Conditions

While it is not expected of you to diagnose foot conditions (that’s the doctor’s job), you should still be able to tell when there is a condition that needs the attention of a podiatrist.

Common foot conditions include:

Athlete’s Foot: A scaly, itchy rash around the toes and sides of the feet.

Fungal Nails: Thick, brittle, yellow nails.

Ingrown Toenails: Nails pushing into the skin, causing it to be red and swollen and sometimes oozing pus if infection is present.

Open sores: Keep a close eye on any signs of an open sore. Keep the area clean and dry.  If your client is a diabetic or has neuropathy, visit a podiatrist immediately!

Dry and Cracked Skin: cracked skin can be an invitation to an infection and is very uncomfortable.

Other signs of discomfort:

Tight fitting shoes: leave seam indentations on the client’s foot, promotes blisters and ingrown toenails.

Remember, examining your patient’s feet daily should be a part of your regular care routine. Look for pressure points caused by shoes, overgrown nails, thick nails, callus build up, dry skin, open sores and signs of infection.  If you are not able to care for your client’s feet, feel overwhelmed at the condition of their feet or just aren’t sure the correct method of treatment, reach out to your local podiatrist. They will be able to guide you in the right direction and help you to help keep your client’s feet happy and healthy.

If you are in the Sonoma County area and are in need of a podiatrist for you or your client, please call us today at (707) 578-1222 to schedule an appointment.

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