June 2017

Bone tumors, both benign and malignant, can affect any bone in the body. Whether or not they are cancerous, bone tumors tend to weaken bone as cells rapidly divide to form a new growth of abnormal tissue. The weakened bone can then be more easily fractured from stress or injury.

Identifying a bone tumor:

Usually a patient will feel pain in the area of the tumor. Instead of a sharp pain, it can be a dull or achy pain that increases with activity. Night sweats and fevers may accompany these symptoms. However, some may not even feel pain, but instead notice a lump or mass growing on the foot. A medical examination, including X-rays and even biopsies may be required to properly diagnose a tumor, and to determine whether or not it is cancerous.

In most cases, tumors are noncancerous. These benign tumors can happen due to trauma to the toes or just from hereditary factors. The following are some common bone tumors:

• Subungual Exotosis – This can happen due to trauma or injury, in which a small bone spur develops under the toenail. When they cause pain, the removal of the spur can relieve symptoms.
• Enchondroma – This cartilaginous tumor is common in the hands and feet. The tumor causes the small tubular bones to weaken and leaves thinned bones to easily break. If it develops right below the toenail, it can feel like the pain of an ingrown toenail.
• Osteochondromas – These benign tumors tend to grow on long tubular bones and do not always cause pain. If this tumor develops under the nail, it can cause a toenail deformity and lead to ingrown toenails. A hereditary condition, it tends to happen more in males and occurs on both sides of the body. The best treatment for this tumor is surgical removal.
• Ollier’s Disease (enchondromatosis) – This disease tends to affect small bones in the hands and feet. It tends to affect only one foot, and has a possibility of transforming into cancer.
• Maffucci’s Syndrome – This tumor growth is a rare type of enchondromatosis and has a greater chance of turning cancerous.

When a bone tumor is found to be cancerous, it usually is found to have spread (metastasized) from another part of the body; breast, lung, and prostate cancers tend to spread to bones.

Bone tumors, both benign and malignant, can be treated with medication or surgical removal, depending on the developmental stage. Radiation therapy and/or chemotherapy may also be used for bones with cancer.

If you suspect a tumor growth in your feet, come see us right away. Dr. Jonathan M. Kletz of Texas Foot Workscan help you identify the problem and diagnose your bony growth. Make an appointment today at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices.

Your body goes through a lot of changes during pregnancy – the belly becomes bigger and rounder, hormones change and fluctuate, bones shift, and some parts of your body swells. In particular, your feet can undergo much more stress than they normally do in order to keep you active and stable.

Some foot problems pregnant women may encounter include:

• Pain along the plantar fascia (ligament on the bottom of your feet) – As you carry more weight, the feet have to work harder and undergo much more pressure than they are used to. Excess weight can even change your feet to be flat feet.
• Swelling – Blood and fluid alone can be the cause of up to 20 pounds of weight gain during pregnancy. Long periods of standing, sitting, or work (including walking) can prevent circulation and cause swelling.
• Instability – With swelling and extra pressure on the feet, it’s possible that your feet can be less alert and sensitive. This can cause instability, especially if you are in high heels.

To combat these problems, here are some tips for keeping your feet happy:

• Be active – Long periods of inactivity (or too much activity) can cause pain and swelling for your feet. If you have an office job, try to get up, stand, and move your feet as much as possible to increase circulation.
• Hydrate – This will also help you with circulation, as well as give you an excuse to move with trips to the restroom!
• Wear compression socks – this will help prevent swelling in the feet and ankles.
• Relax in a warm Epsom salt, cold Tonic water, or warm Grapefruit Essential Oil foot soak – This is a great way to give your feet some pain relief, as well as reduce swelling.
• Get a foot rub – If possible, get regular foot massages to pamper your tired, hard-working feet. At home, have your partner give you a foot rub and/or roll your feet on a lacrosse or golf ball for a nice massage along your plantar fascia.
• Elevate your feet above heart level to reduce swelling in your feet.
• Wear shoes that fit you. If your nice shoes are giving you pain, you may need to put them away for the pregnancy. Instead, find athletic shoes that will give you comfort and support to protect your precious cargo from unstable situations. Additionally, it will prevent pain or swelling from uncomfortable footwear.
• Use orthotic inserts if your arches have flatten due to weight gain - Arch supports and good cushioning should do the trick.

If you feel that you are swelling excessively, or if the swelling is occurring unevenly (in one leg and not the other), contact your doctor right away. Swelling is not necessarily normal in all parts of the body and may indicate a more severe problem. If you are concerned about swelling in your legs or need assistance with finding relief, Dr. Jonathan M. Kletz of Texas Foot Works is more than happy to help you. Make an appointment today at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices.

Gymnastics is one of those sports, where the athletes make it look so easy. Unless you’ve tried it, you may think that it’s just something that you just need to practice. However, it takes years and years of training, conditioning, and strengthening to build muscles and have your body learn to move in that smooth, sleek fashion. It also takes trial and error, and more likely than not, injuries to the feet and ankles. That’s why gymnasts must learn early on, how to protect their feet and ankles to prevent injury. Not taking precautions, such as the ones listed below can lead to many painful injuries:

• Coaches should be made aware of any chronic or developmental issues, as well as any previous injuries.
• Strength, Balance, and Flexibility exercises should be taken seriously and gymnasts should make sure to do adequate warm-up before they practice, practice, practice their technique.
• Use tape or wraps to help with certain strains or injuries to the feet or ankles to prevent from worsening.
• Do not attempt new techniques without adequate preparation, the right safety equipment, and a confident attitude. Children, especially, should not be forced to try difficult or possibly dangerous techniques without a good mindset.
• See a doctor promptly if you sustain a severe injury. For mild sprains, use the RICE method (Rest, Ice, Compression, Elevation) to relieve pain. If pain persists or gets worse, make an appointment to see our podiatrist.

Not taking steps to reduce risk of injury can lead to serious injury. Gymnasts can expect to experience muscle soreness, in which recovery and hydration is key, but other conditions require more attention. Look for signs of the following common injuries:

• Sprained or Twisted Ankles – A loss of balance or improper landing can lead to an ankle injury. Most likely, there will be pain at the moment of injury or when the gymnast tries to put weight on it. If the pain and/or swelling is mild, try the RICE method. If the injury is severe, see a doctor immediately. 
• Stress Fractures and Acute Fractures – While broken bones are not as common as sprained, fractures can occur. Stress fractures can build under repetitive pressure while acute fractures can happen from an improper position or landing. If you cannot bear weight or have excruciating pain, see a doctor immediately.
• Overuse Injuries such as Achilles Tendonitis or Joint Pain – Certain repetitive motions, unprotected high impact landings, and lack of good technique or form can lead to many different overuse injuries. At the first sign of pain in any part of the body, it’s best to have it checked instead of ignoring it or “shaking it off” as it can get worse over time.

If you or your child has a gymnastics-related foot or ankle injury, make an appointment to come see us ASAP. Early treatment can mean better results so that we can have you back at practice. Dr. Jonathan M. Kletz of Texas Foot Works is more than happy to help you at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices.

Are you prone to injuring your ankles? For those who have weak or previously injured ankles, twists, rolls, sprains, strains, and even fractures can seem to happen often. It can occur while playing sports, hiking, running, and even walking (especially in high heels). Injuries at the ankle can cause pain, swelling, and tenderness. For the most part, the RICE (rest, ice, compression, elevation) method can help relieve symptoms, but if they persist, it may indicate a more severe issue.

Many of these injuries happen because ankles are not very flexible or strong. Lacking a strong sense of balance can also attribute to this, which is why the following exercises for stretching, strengthening, and balancing with your ankles will help you reduce risk of ankle injuries. Try to incorporate some of these exercises into your weekly workout routine, or do them as you watch TV or when you have other downtime:

(For those with repetitive movements, try to do 15 repetitions for 3 sets to get maximum results – increase reps as you can.)

Flex and Point: While sitting, stretch your legs out in front of you and flex and point, each for 3 seconds. To add a challenge, use a towel or band to increase resistance while pointing.

Calf Raises: Slowly lift up onto the tiptoes and slowly lower down.

Ankle Pushes: Place your foot against a heavy or stationary object like a couch or refrigerator. Push the outer part of the ankle against the object, then push the inner part of the ankle against the object, each for at least 10 seconds.

Heel Walking: Try to balance on your heels with your feet flexed (toes pointing up). Try walking across the room and back, resting in between each round-trip journey.

Balancing Bars: Stand next to a stable bar, such as stair railing, couch, or ballet bar. For first timers, hold the bar while you do some squats (feet facing forward) and then ballet pliés (with your feet pointing away from each other).

Yoga Tree Pose: Stand on one foot with the other foot resting flat against the ankle. Start by holding this position for at least 15 seconds. Switch and do the other side. To challenge yourself more, raise the non-standing foot to the inside of the other knee. A 3rd level of challenge is to raise the foot to the inside of the thigh.  

If you have ankles that are prone to injury, or if you have an injured ankle, it’s best to get it checked out to make sure it’s not serious. Before beginning exercises like those mentioned above, it’s best to consult with our podiatrist. Dr. Jonathan M. Kletz of Texas Foot Works is more than happy to help you with your ankles. Make an appointment today at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices.