December 2017

It’s not easy to stay active when you have a foot or ankle injury. Most exercises you can do at home or at the gym usually involve the feet and ankles, so you may feel discouraged from physical activity. For some of you, you might be happy to have an “excuse” to not participate in exercise!

Sorry to burst your bubble, but there are alternative exercises you can try. We encourage you to keep active because it can increase circulation and promote faster recovery, as long as you allow your foot or ankle injury to rest and heal.

If your injury is not severe and you can still move your foot or ankle in low-impact exercises, try the following:

• Swimming is easy on the joints, and it’s a great cardiovascular exercise that does not involve bearing weight on your feet.
• If you can use your feet in a rowing machine, that’s also a good way to get the blood pumping and exercise your upper body and core.
• If you’re able to make circular motions with your feet, a recumbent bike is another great way to get a cardiovascular workout.
• Push-Ups can be done, either with more weight put on the uninjured foot, or with the injured foot resting on the uninjured foot. You can also do modified push-ups on your knees.

If you cannot put any weight on the feet or ankles, try some of the following:

• Arm curls, tricep extensions, overhead presses, and other workouts with free weights can be done while sitting on a bench, without any weight on the injured foot.
• Leg and arm workout machines, such as leg extensions, leg curls, lat pull downs, and other seated workouts that do not involve the feet and ankles can be done to work out many different body parts.
• Use a step stool to step up to reach pull-up bars to do hangs and pull-ups.
• Ab and core workouts don’t always need your feet or ankles involved. Rest your feet up on a workout bench and do some crunches or mason twists.

Before starting a new workout regimen, be sure to check with our podiatrist, Dr. Jonathan M. Kletz for a proper assessment. Make an appointment today at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices so that we can help you stay active and get back on your feet!

Who can be affected by fungal toenails?

The fungus can infect anyone with toenails. Those with weak immune systems are less likely to be able to fight it off.

What is it?

Fungal toenails, or Onychomycosis, is a fungal infection that is caused by the same fungus tinea that results in athlete’s foot, jock itch, and ringworm. It can cause toenails to become thick, hard, yellow or gray, and brittle. They are contagious and can be unsightly.

When are you most likely to be affected?

Fungal toenails can arise when the fungus enters the skin and nails through cuts, scrapes, and/or when people have weakened immune systems. Any wounds should be treated promptly to prevent fungal, viral, and bacterial infections. Those who are sick, have poor circulation, have diabetes, or have skin conditions like eczema or psoriasis are more at risk of being affected by fungal toenails and athlete’s foot.

Where did you get it?

The tinea fungus grows in dark, damp, and warm places, such as in shoes, locker room floors, communal showers, and shared towels or toenail clippers.

Why is it important to treat?

Not only do they affect your toenail health, making them more prone to breaking, they are also embarrassing and unsightly. Additionally, you can spread them to family or other members of your gym if you fail to keep up hygienic practices, such as wearing protective footwear in communal areas and not sharing towels.

How do you treat it?

Depending on how long you’ve had the condition and how severe it is, treatment options include:

• Over-the-counter antifungal topical medications
• Prescribed antifungal topical medications
• Prescribed oral medications (which can have side effects such as abdominal pain and diarrhea, as well as liver or heart damage).
• Antifungal nail polish

Hyperblue Laser therapy at our office (several painless treatments with no recovery period)

Are you sick of battling with fungal toenails? Come see our podiatrist, Dr. Jonathan M. Kletz for prompt treatment. Make an appointment today at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices so that we can help you regain your nail health!

No, we are not talking about the grain, but rather, the RICE method. The letters R, I, C, and E in RICE methodstand for: Rest, Ice, Compression, and Elevation. After a foot or ankle injury, applying the RICE method can help to relieve pain and swelling symptoms. It is used until the injury heals, or if symptoms do not get better, until you can be seen by a medical professional for further treatment.

Please note: For severe injuries, especially if you suspect a broken bone or torn ligament, you should seek prompt medical attention at urgent care or the emergency department.

For mild or moderate injuries, such as a bruise from a heavy object or a sprained ankle, or even pain from overuse injuries like Achilles tendonitis or Plantar fasciitis, the RICE method can be very effective. Read on for a more detailed description of each of the components of the RICE method:

“R” is for “Rest” - Stop what you are doing. Whether it is playing a sport, walking to work, or jogging in the park, you should immediately stop and assess your injured foot or ankle. If possible, do not put weight on it and if necessary, sit down to prevent further injury.

This can also apply to resting from the activity you are doing to allow your injury to fully heal. If you were playing a sport, you may have to sit out the rest of the game, or the season to fully “rest” your foot or ankle. If you are a ballet dancer, it may mean missing the next performance or more. Look at it this way: it’s better to miss a little now, than to risk not being able to do it at all.

“I” is for “Ice” - Apply a cold compress or ice on the injured are for 15 to 20 minutes at a time. This will prevent or reduce swelling and numb some of the pain.

“C” is for “Compression” - To promote healing and reduce or prevent swelling, you can use compression socks or bandages on the injured area. Even after a few hours, you can use compression to support your injured leg until it heals.

“E” is for “Elevation” - Whenever possible, keep your injury elevated above heart level (or at least level to your hip when you are sitting). This will also prevent or reduce swelling to the injured area.

Have you experienced an injury that won’t get better within a couple days? You should consult with our podiatrist, Dr. Jonathan M. Kletz, at Texas Foot Works. He will assess your foot or ankle injury to get you the right treatment. Make an appointment today at our offices located in Abrams (Dallas), Athens, and Gun Barrell City, TX!

For most, plantar fasciitis pain comes on gradually. Your plantar fascia (fibrous tissue along the bottom of the feet) helps you stay mobile and connects the balls of the feet to your heel bone. Repetitive movements often required in sports or certain jobs can make it become inflamed.

If you notice that the bottom of your feet feel sore or tight, try one or more of the following 10 home remedies to prevent the pain from getting worse:

1. RICE method: Rest, Ice, Compression (bandage or socks), Elevate. These are the first actions you should take when you encounter pain, especially if it won’t go away after a few seconds. Doing these often will help prevent the injury from getting worse, especially if it’s an overuse injury.
2. Stretch when you wake up: There are a few ways to stretch the calves and the plantar fascia. Try this one before you take your first steps in the morning: stretch the bottom of the feet by bending at your hips and reaching for your toes. Pull the toes back so that you feel the stretch along the soles of your feet. If you can’t reach, use a band or towel to pull on the top of the foot.
3. Massage the plantar fascia: When you have your foot across your knee with the soles facing up, you can feel the plantar fascia tighten up. Rub the area up and down along the band of tissues.
4. Use a golf, lacrosse, or handball: Whether you’re sitting at work or at home in front of the TV, give the soles of your feet a massage by rolling the ball on the ground using your foot. Rolling it around can stimulate circulation and healing. Pushing down on pressure points will give you relief.
5. Soak your feet in a warm bath: Epsom salt can relieve tightness and can encourage healing when added to the bath.
6. Use orthotics: Whether it is over-the-counter or custom-made by our podiatrist, orthotics can help displace the strains of the feet while you go about your day-to-day activities.
7. Change your shoes: If you wear flats, high heels, or other shoes with poor support, your feet will continue to feel terrible in them. Find better shoes and stick to supportive, cushioned shoes to prevent worse symptoms.
8. Change your workout routine: Chances are, athletes who have repeatedly stressed their plantar fascia will suffer most from fasciitis pain. Unless it’s unavoidable, change your exercise for a while to allow the plantar fascia to rest. Or take breaks often while you exercise. Try not to increase weight or speed too rapidly, as this can also irritate the plantar fascia.
9. Splint your feet at night: For some, using a night splint can be helpful. It immobilizes the feet in the flexed position so that they do not strain while you are sleeping. This can help prevent morning pain.
10. Toe exercises: Strengthen your feet by doing foot and toe exercises, such as picking up and moving marbles or a small towel.

If your plantar fasciitis pain does not get better after trying some of these home treatments, consult with our podiatrist, Dr. Jonathan M. Kletz, at Texas Foot Works. Our foot doctor will assess your feet to get you the right treatment. Make an appointment today at any of our offices in Abrams (Dallas), Athens, and Gun Barrell City!

Osteoporosis, a disease in which your bones slowly lose more calcium than it absorbs, is usually thought of as a disease that your grandparents get and suffer from. And for the most part, that’s true. However, those with early onset osteoporosis can be diagnosed even before the more typical age of 50 years old.

The good news is that it can be prevented or slowed with good nutrition and strength training exercises. Even after diagnosis, medications are available that may help slow the bone loss process and even restart bone building.

How do your feet come into play?

Don’t forget, each foot is made of 26 bones, which means that the feet account for about a quarter of the all the bones in the body. This means that osteoporosis, a systemic disease of the bones, is likely to affect your feet and ankles.

Since your feet have to bear the weight of your entire body, that puts more pressure on them as they endure impact on the ground. The feet and ankles are more likely to experience:

• bone pain at the top of the foot
• fractures from a small injury, or even just from walking!

In fact, the bones can become so brittle that when you go in for a checkup on pain, redness, and swelling on your feet, our podiatrist may detect a fracture, and also determine that you may have osteoporosis. That’s right, some people find out they have osteoporosis because of a foot fracture!

What can you do to reduce risks

• Start young. Learn how to eat well and strengthen your body and bones when you are an active young adult. It’s best to develop healthy habits to carry through your life.
• Eat well. Be sure to have a diet rich in calcium and vitamin D. Vitamin D is necessary for good calcium absorption into the bones. Some foods, like high sodium prepackaged dinners and fizzy soda with phosphoric acid can adversely affect calcium absorption into the bones.
• Exercise often and with resistance or weights. This will help to make the bones denser, reducing the risk of weak, brittle bones later.
• Get assessed at your physicals if it runs in your family. This is especially important for women after menopause begins since hormone changes can affect calcium absorption and loss.
• Stop smoking. Smoking has shown to increase risk of osteoporosis.

Do you or someone in your family have osteoporosis? It may be passed down genetically, so consult with our podiatrist, Dr. Jonathan M. Kletz, at Texas Foot Works. He will assess your feet to get you the right diagnosis so that you can get the appropriate treatment. Make an appointment today at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices!

Did you know that diabetes can affect not only your blood sugar levels, but can also be damaging to your kidneys, eyes, nerves, and feet? In fact, for those who do not have severe symptoms, losing feeling in the feet can be the first sign of diabetes. After an assessment by a podiatrist or other medical professional, patients with this condition, known as neuropathy, in the feet can eventually be diagnosed with diabetes.

Unfortunately, it doesn’t stop there. Neuropathy is a result of nerve damage due to high levels of blood sugar. It can have effects beyond a loss of sensation – it can lead to reduced circulation and healing, because your body can no longer communicate properly to serve your feet’s needs. The smallest cuts or injuries can become larger issues, such as ulcers. That’s why it’s important to take care of your feet, whether or not you have diabetes. After all, about 10% of the US population has diabetes (including those who are not yet diagnosed).

The following are diabetic foot exam steps that you can perform on your own. It can help you to find signs of diabetes-related foot problems that you can treat sooner, rather than later. If you have already lost sensation in your feet, be sure to check your feet daily:

1. Whether or not you have diabetes, be sure to keep up with foot hygiene. Wash your feet daily with soap and warm water to prevent infections.
2. Visually inspect your feet. Look for any skin changes, cuts, rashes, or bruises you may not have realized you have. Be sure to look at the feet from all angles – top, bottom, both sides, front, and back. If you are not flexible enough to turn your foot up so you can see the bottom, use a mirror or ask a family member to check for you.
3. Touch every part of your foot. Lightly press on all parts of your feet to check for swelling or bruising. Also take note of the skin on your feet and check for temperature variation, dryness, calluses, or bumps from rashes or bony spurs. Be sure to moisturize dry skin on your feet and ankles, but don’t put any lotion in between the toes as this can cause fungal infection. 

Foot care for diabetics is very important. If you notice any changes in your feet, consult with our podiatrist, Dr. Jonathan M. Kletz, at Texas Foot Works right away. He will assess your feet and ankles to see what treatment you may need. Since an unnoticed problem can become way worse and more difficult to treat, it’s important that you make an appointment today at any of our offices in Abrams (Dallas), Athens, and Gun Barrell City, TX!

In many cases of acute injuries, as well as with chronic pain symptoms, podiatrists will often prescribe orthoticsas part of rehabilitation or pain management. Depending on the reason for prescribing orthotics, they can be useful for prevention of future problems (e.g. when used for children), immobilizing injuries to prevent worsening symptoms (e.g. after foot or ankle surgery), and for treating painful symptoms of foot or ankle deformities.

There are generally two types of orthotics that our foot doctor will prescribe: accommodative foot orthoses and functional foot orthoses.

Accommodative orthotics are:

• Generally made of more flexible or soft materials such as leather, foam cushions, and rubber.
• Used to provide extra support or relieve pressure from a painful area.
• Typically used for treatment of minor pain caused by diabetic foot ulcers, corns and calluses, and bunions.

Functional orthotics are:

• Generally made of flexible, semi-rigid, or rigid plastic or graphite materials.
• Used to control pain or prevent worsening problems due to abnormal function.
• Typically used for treatment of conditions like big toe joint pain, tendonitis, bursitis, and plantar fasciitis.
• Additionally, children may require orthotic inserts or custom orthotic shoes to control problems with pediatric flat feet, in- and out-toeing, or other injury to the growth plates.

Both are created by taking a mold of your feet and/or ankles using plaster or foam. Mechanical or optical scanners can also help to take measurements for an accurate fit. This process takes place during an office visit, taking into consideration your footprint, gait, and any inflammation or deformity in the feet or ankles. The end goal is to either relieve symptoms so that you can resume normal activities without pain, or to deter/correct a deformity that can keep getting worse.

For additional questions regarding how orthotics can help your foot or ankle pain, consult with our podiatrist, Dr. Jonathan M. Kletz, at Texas Foot Works. He will assess your feet and ankles to see if orthotics will work for you. Make an appointment today at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices!

Even post-Thanksgiving, there’s a lot of traveling you might have to do. The December holidays, as well as New Year’s Eve celebrations, not to mention skiing or snowboarding trips, can mean more flights and/or bus rides coming up. As you pack your bags and try to remember every single item you may need, we have a few extra suggestions for you. The following “Top 10 Tips for Traveling Feet” will (hopefully) remind you that your feet, which carry you everywhere, will need some care while taking you on your travels:

1. Pack comfortable walking shoes. Depending on the reason for travel, you’ll likely need at least two pairs of shoes. Comfortable walking shoes that fit properly are a must, especially if you’ll be doing some exploring or spending more than 10 minutes walking around your travel destination.
2. Pack activity-specific shoes. If you are going for a formal event, you’ll want to pack your fancy shoes, but don’t depend on them for regular use. Are you going hiking during this trip? You’ll want to bring the activity-specific shoes so that you don’t risk injury because you’re wearing the wrong shoes.
3. Buy a pair (or 2) of orthotic inserts. This is especially important if your walking shoes are not providing enough support, as well as for formal shoes, like in high heels. Orthotic inserts can help reduce pressure on the midfoot.
4. Bring a pair of flip-flops. Even in the winter? Yes. If you can bring a pair of clean flip-flops, they will be useful in so many ways: on long-distance flights, walking around a hotel room and shower, keeping your feet off the dirty or cold floors of your relatives’ home, and especially if you’ll be using any communal showers, like at a gym or spa (to prevent contracting foot diseases).
5. Pack extra socks. If your feet tend to sweat a lot and cause foot odor, you’ll want to change your socks at least once each day. Staying in soggy, smelly socks will not only be uncomfortable, but can also make you more prone to chafing and infection.
6. Wash your feet each night. This is something you should do each night anyway, but while traveling, it gives you a chance to relax and inspect your feet for any issues.
7. Treating cuts or blisters. Earlier is better than trying to deal with them later when you get back home. You may want to bring (at least) some antibiotic ointment if you won’t have access to it at your travel destination.
8. Stretch and massage the feet. Have you had a long day of walking around? Danced the night away? Stood all day helping with cooking for the holiday meal? Thank your feet for supporting you by stretching them and giving them a nice rub.
9. Keep your feet moving. If you’ll be sitting or standing for a long period of time (such as on the plane or waiting in line shopping for deals), wiggle your toes, make foot circles, and whatever else you can think of to keep blood circulating to and from your feet to prevent swelling.
10. Rest. If you have foot issues, it’s important to schedule rest periods. Overworking feet with weak or painful ankles, for example, could lead to more painful issues later.

For questions regarding travel and your feet, consult with our podiatrist, Dr. Jonathan M. Kletz, at Texas Foot Works. He will assess your feet and ankles to give you tips for a smooth trip. Make an appointment today at any of our offices in Abrams (Dallas), Athens, and Gun Barrell City, TX!

Foot and ankle injuries are common among people who participate in sports. Several factors contribute to this. They include failing to stretch or warm up properly, not wearing the proper type of shoe and not taping or providing other types of support for the ankle or foot. The most common foot and ankle injuries suffered by people involved in sport are plantar fasciitis, ankle sprains and Achilles tendon damage or ruptures. If not treated properly they can lead to permanent disability.

Plantar fasciitis is a painful condition. It is inflammation of the plantar fascia, the thick fibrous band of tissue running from the heel to the base of the toes. There are several effective treatments for this ailment. Doctors often proscribe rest, massages, stretching, night splints, physical therapy, anti-inflammatory medication, corticosteroids or surgery usually in that order. The most effective treatment for plantar fasciitis is orthotics, such as foot supports. Surgery is occasionally used as a last resort.

The Achilles tendon is the largest tendon in the body. It connects the calf muscles to the heel bone. Running, jumping and walking all impact this tendon. Two common injuries to the Achilles tendon are tendonitis and a rupture of the tendon. Tendonitis is inflammation in the tendon often caused by an increase in the amount and intensity of stress placed on it. It can either be treated non-surgically with rest, ice or anti-inflammatory medication or surgery may be required. A rupture (tear) of the Achilles tendon can be treated by placing the lower leg in a cast for several weeks or with surgery. Many physicians feel surgery is the better option because it lowers the risk of re-ruptures. Both methods require 4 to 6 months of rehabilitation.

Ankle sprains are the most common sports related foot and ankle injury. A sprain occurs when the ligament holding the ankle bones and joint stretches beyond its normal range. It can be treated non-surgically with a combination of rest, ice wrapped around the joint for 30 minutes immediately after injury, compression by a bandage and elevating the ankle above the heart for 48 hours. This combination is referred to as RICE. Severe ankle sprains in which the ligaments are torn may require arthroscopic or reconstructive surgery followed by rehabilitation

Treating these injuries is relatively simple if they are identified and addressed early. Many athletes dismiss the initial aches and pains associated with injury as just soreness or tired muscles. Their first response is usually to try to work through it. This can lead to serious problems. Many minor injuries are made far more serious when athletes continue to put strain and pressure on them. That attitude can change a mild strain into a serious strain and a minor tear into a rupture. Athletes should have unusual aches and pains evaluated by a skilled, licensed medical professional.