December 2017

Have you been dealing with unattractive toenail fungus (Onchyomycosis)? The anti-fungal creams just aren’t cutting it and the only way to cover it up is with socks and shoes or with nail polish. Don’t be embarrassed by your toenails any longer! At Texas Foot Works, we have the solution right here in our office.

We offer you the technology of laser treatments, which can safely and painlessly treat your toenail fungus! Our laser treatments use specific wavelengths of light to target fungus that survive under the toenails, which are unreachable with creams and other medication. And unlike the many possible side effects that come with oral anti-fungal medications like, abdominal pain, diarrhea, rash, and liver damage or heart failure, there are no side effects for laser therapy.

What is Laser Treatment like?

• You’ll come to our office for 3 or more treatments, depending on the severity of your fungal infection.
• Each treatment will take under 10 minutes.
• There is little or no discomfort, and there is no anesthesia involved.
• There is no ointments or solutions used on the affected area, only the focused laser beams, which you won’t feel.
• There is no recovery period, so you can walk in, get treated, and walk out. You can even apply toenail polish in between treatments (but it needs to come off for treatment).
• It does not damage the toenail or surrounding skin or tissues.

The treatments will kill the fungi that are growing under the toenail. It will prevent new toenail growth from having the unattractiveness of fungal toenails and revitalized growth will begin again. While the treatment does not guarantee that the fungus will not come back, you can take measures like practicing daily preventative hygiene habits. Our podiatrist may also suggest preventative maintenance treatment.

Are you ready to get rid of those ugly 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 rejuvenate your toenails!

Our feet and ankles are subject to many different problems because of the roles they play in carrying us around and keeping us fit each day. They include acute and chronic pain issues that often do not have a quick and easy treatment. Enter, EPAT.

EPAT, or Extracorporeal Pulse Activation Technology is an FDA-cleared, noninvasive treatment for a range of musculoskeletal issues. According to the Curamedix brochure about EPAT, “This proprietary technology is based on a unique set of pressure waves that stimulate the metabolism, enhance blood circulation and accelerate the healing process. Damaged tissue gradually regenerates and eventually heals.”

How can EPAT help me?

EPAT Treatment is used for many conditions, including these common foot problems:

• Plantar Fasciitis
• Heel Pain
• Achilles Tendinitis
• Scar adhesions in the foot and ankle
• Morton’s Neuroma
• Sesamoiditis
• Acute and Chronic Muscle Pain

A coupling gel is applied to the treatment area and then the handheld probe is placed and held there during the therapy. Because there is no surgery, anesthesia, or recovery period for EPAT treatment, patients can resume activities right after a treatment session. For some, a lingering discomfort may exist for a few days, but it should not interfere with activity. The treatments are quick and painless – taking only 5 to 10 minutes over 3+ weekly sessions. Many can feel relief after just a few sessions!

Do you have acute or chronic pain in your feet or ankles? Have you had a foot issue that’s been persistently bothering you? Come see our podiatrist, Dr. Jonathan M. Kletz at Texas Foot Works. Make an appointment today at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices so that we can help you find pain relief using our EPAT Treatment.

Got bunions? Don’t worry – you’re not alone. Catherine Zeta-Jones, JLo, and Amy Adams are just a few celebrities that have been sighted with the problem. It’s not really a surprise, though since women are more prone to having foot issues then men are. It’s most likely due to the types of shoes that women wear, often sacrificing comfort for fashion.

What are bunions?

While it can begin with genetics, shoes that force the toes into a specific shape can aggravate this common problem of the big toe joint (and sometimes the pinky toe). Additionally, foot injuries, birth deformities, ill-fitting and unsupportive shoes, as well as changes in gait due to arthritis can cause bunions or make them worse.

When there is uneven pressure applied to the big toe joint, it can become misaligned and/or a bony growth can begin to stick out to try to support this pressure. For some, this deformity can be painless, but for others, it can be painful – in addition to being unsightly. If it is left untreated, complications can arise including bursitis, hammertoe, or metatarsalgia.

How do you treat bunions?

If you have pain and swelling, it’s important to get treatment sooner than later. Our podiatrist, Dr. Jonathan M. Kletz, can properly diagnose the issue and determine the cause of your bunions. Then, he can prescribe the proper treatment that may include one or more of the following:

• Physical therapy/exercises to strengthen the muscles around the toe to keep the joint in place.
• Over-the-counter NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen or aspirin, and/or gels to reduce inflammation, swelling, and pain.
• Bunion pads may be helpful to reduce friction and rubbing in shoes.
• Custom orthotics may be required to give you the proper support in your feet and reduce irritation to the bunions.
• In severe cases, surgery may be required to correct joint issues or remove some of the bony protrusions.

For bunion treatment, contact us at Texas Foot Works. Make an appointment today at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices so that we can help you find pain relief from bunions.

Millions of people are affected with diabetes each year. Diabetes damages blood vessels in all parts of the body, especially the feet. The legs and feet may develop slow blood flow, which causes neuropathy (nerve damage). Once a diabetic patient develops neuropathy, it is important that the feet are well taken care of, or else the lower limbs may have to be amputated. This only happens in drastic cases, but it shows how seriously diabetic foot care should be taken.

It is very important to always wash and dry the feet thoroughly, especially in between the toes, when diabetic. Secondly, examining your feet and toes for redness or sores must be done, even if you do not feel pain. You may also want to examine your feet from the bottom. Try to avoid wearing colored socks to prevent infections that may occur from the die. Additionally, well-fitting socks are highly recommended.

A diabetic’s physician should always monitor their Hemoglobin A1C levels to test how well the blood sugars are being controlled during the past 3 months. It is very important to keep blood sugar levels at normal range, 70-110mg/dl. In addition to giving advice about everyday eating habits and foot care, a physician may prescribe medicine to help with neuropathy of a diabetic patient. It is also advised to see a podiatrist if experiencing any feet conditions. Toe nails may also need to be taken care of by a podiatrist, since some patients may cut too deep around the cuticles, causing infection.

A person can take care of their feet at home by following the instructions of their physician. Using creams on one’s feet is also an effective way to heal dryness. When using tools to remove calluses, use caution, as severe diabetics may not be able to feel pain on their feet. If any complications arise do not hesitate to call a podiatrist.

On a daily basis, diabetic feet must be checked. If you are ever concerned about something, contact your health care professional. You never want to wait until a wound gets too bad to treat. If left untreated, gangrene may develop. Gangrene is a serious infection that can cause in diabetics that can lead to sepsis or amputation. It is also important for diabetics to be on the lookout for ulcers. Ulcers are sores that develop from tissue loss on the skin. They can be quite painful and require intensive treatment. Early treatment and everyday inspection are imperative to staying healthy.

When you have a deformity in the first joint of the toe making it point up and then down, it’s called a hammertoe. The tip of the toe may still be flat, but between that and the foot, there is an upside-down V. It may or may not cause pain, but it needs to be treated if it causes swelling and redness of the toe, has a painful corn on top, gives you pain at the base of your toe, and/or causes pain when you try to move the toe.

Hammertoes can be caused by abnormal development of muscle tissue in the toes, hereditary factors, trauma, arthritis, and wearing shoes that are too tight. When it is caught early, flexible hammertoes are more easily treatable with padding and taping. However after a long time, they become rigid hammertoes, which may make surgery the only option.

If you have noticed that you may have some mild symptoms of hammertoe, you can try some at-home treatments such as:

• Wear shoes that are roomier and more comfortable around the toes. This will prevent further deformity and reduce pressures that might cause a corn or blister.
• If you’ve got pain and swelling in your toe(s), apply an ice pack several times a day to reduce inflammation.
• A hammertoe pad can be used on the top of the bent toe to reduce pressure and friction.
• Use a pumice stone to reduce the size of a corn or callus on your toe after a warm soak.
• Try some exercises like picking up small objects with your toes to stretch and strengthen your toes.

If these remedies don’t work, contact us at Texas Foot Works. Our podiatrist, Dr. Jonathan M. Kletz, can assess the problem and give you the best treatment option for your particular case. He may suggest padding and taping the toes to protect and straighten them to correct the imbalance. For pain, he may prescribe anti-inflammatory drugs or give you cortisone injection. Custom orthotic inserts may help to support your feet and prevent worsening symptoms. If the toe deformity and pain become severe, surgery may be the only option to relieve your issues. Make an appointment today at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices so that we can help you find pain relief from hammertoes.

Many of us lead busy lives, which often makes us forget about self-care, let alone foot care. Our feet often get neglected, even though they carry us everywhere, every day! It’s time to appreciate our feet. At Texas Foot Works, we want you to care for your feet. We have come up with some simple ways to practice good hygiene and remember to care for your feet at home.

• Leave your shoes and your work at the door. When you get home, it’s time to relax and enjoy yourself, whether it be with your favorite meal and TV show, or with your family. For everyone’s health and well-being, your work should be left at work and your germ-covered shoes should be left at the door. If you’ve really been all over the place, give your shoes a once over with anti-germ spray, inside and out.
• Have more than one pair of shoes to wear to work and put them into rotation. If you have to wear a suit and tie to work each day, it may be simpler to wear the same shoes each day, but you risk an issue with foot odor and bacteria build up. If you really only like one pair of shoes, get 2 or 3 pairs of the same and rotate them.
• Wearing slippers or indoor shoes in the house? Make sure they have grip if you have hardwood or tile floors. If you have carpet, the bottom should be smooth so that you do not trip up on the carpet pile.
• Mats, mats, mats. Having a mat in your kitchen will help you prevent backaches while cooking or cleaning. The same goes for any areas where you might stand for a long time – crafting table, painting easel, or standing desk. Bath mats and bathtub rubber mats will prevent slips and falls on wet surfaces.
• If you do not have carpet on the stairs, safety can be achieved with anti-slip strips or a stair liner to prevent slipping while going up or down the stairs. Children and older adults will thank you! (or you’ll thank yourself for keeping your family safe!)

Have concerns about foot safety and hygiene in the home? Have you been injured by slips or trips at home? Make an appointment today with our podiatrist, Dr. Jonathan M. Kletz. He and his team can help you at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices. A healthy home helps to make a happy home!

Onychocryptosis, commonly known as ingrown toenails, tend to occur on the big toes, but it can affect all the little toes too. The toenail can curve into the skin or the skin may grow thickly around it, causing pain, inflammation, and even bacterial or fungal infections.

What causes you to get ingrown toenails?

• Genetics: Curved toes or toenails can be a hereditary trait. When the toes are curled into each other, the pressure applied by the other toes can cause the nail to grow down and into the skin. People with curved toenails have a natural growth direction downward into the skin.
• Injuries: Blunt trauma to the toenail can leave you with a split, broken toenail, or none at all. When there is an injury involving excessive long-term swelling, the toenail can grow into the swollen skin. For broken or removed toenails, they may grow in as ingrown toenails, since the nail is so short to begin with and the skin around can be raised.
• Constant pressure from shoes: Wearing shoes that are too tight puts pressure on the top or front of the toes. The pressure can cause the nail to grown in such a way that they curve into the skin.
• Improper nail cutting: Toenails should be cut straight across instead of round to prevent ingrown toenails. While the option for rounded toenails might be tempting at the nail salon, make sure you keep in mind the risks, especially if you’re prone to getting ingrown toenails.
• Fungal toenails are usually characterized by hardened toenails, which can grow deeply into the skin.

The best way to deal with ingrown toenails is to be vigilant and prevent them from occurring if you can. Remember to trim your toenails straight across, wear shoes that are not too tight, reduce swelling for any injuries, and treat fungal or bacterial infections quickly.

Do you suffer from painful ingrown toenails? Or maybe you don’t experience pain, but there is uncomfortable pressure that you have to deal with each day. We’re here to help! At Texas Foot Works, we will work with you to find the best solutions for your problems with ingrown toenails. It’s best not to try to pry out your toenails if they are ingrown, as you may further agitate them or cause infection. Our podiatrist, Dr. Jonathan M. Kletz can help you at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices. Make an appointment today so that he can help relieve your pain.  

Ankle and foot orthotics, known as AFOs, are custom-made inserts, shaped and contoured to fit inside a shoe and used to correct an irregular walking gait or provide cushioning. Orthotics come in a variety of different models and sizes, including both over the counter and customizable variants. Customizable ones should be prescribed through a podiatrist who specializes in customized footwear and orthotics design and management.

AFOs are often used by athletes including track and field runners, cyclists, professional dancers, ice skaters, and even golfers. They benefit a lot from custom made AFOs by preventing injuries from occurring and provide cushioning to keep pain levels down to a minimum. Ankle foot orthotics allow for the correct positioning of the feet and also act as shock absorbers to help keep pressure and stress off the foot and ankle. They can also relieve back pain and hip pain while restoring balance and improving an athlete’s performance.

The way they help alleviate pain is by controlling the movement of both your feet and ankles. They are custom designed by a podiatrist or orthopedic specialist to help treat foot problems such as flat feet, spurs, arthritis of the ankle or foot, ankle sprains, weakness, and drop foot, a condition in which the patient cannot raise their foot at the ankle joint.

With custom orthotics, a patient will go through a complete examination of the foot and ankle, followed by the ankle and foot being cast and fitted for the proper orthotic. Depending upon the final result of the tests, a stretching treatment is created with specific shoe fitting in mind. After they have been fitted to the shoes, adjustments can be made in order to get the perfect fit and completely fill out the shoe. Evaluations are then usually set up to monitor the patient in the coming weeks to see how they are adjusting.

AFOs are also available over the counter and are more common than custom fit ones. Athletes that have generally low aches and pains in the foot, ankle, or lower back area can use an over the counter version of these orthotics. Weight is still distributed evenly throughout the bottom of the foot thanks to the arch support they give, but when an injury or ailment occurs, it is usually not enough to try and remedy it with an over the counter version. In either case, a podiatrist will be able to offer the best advice and treatment when it comes to foot and ankle orthotics and handle all your foot care needs.

More than anything, smelly feet can be embarrassing. To remedy the situation, you need to take your feet out of your shoes, but if you do, people around you might smell the horrid odor. So you continue to do your best to hide it. But did you know that it makes the smelly feet situation worse?

Your feet have about 3,000 sweat glands per square inch of feet. As you get hot throughout the day, your body uses these glands to release heat, making parts of your body sweaty. Some people may not sweat as much through the hands and feet, instead releasing heat through the head, armpits, and/or back. For everyone else, hands and feet can easily get sweaty, and cause problems when they are covered. In these cases, sweat leaves through the feet and into the socks. When socks are drenched in sweat, it can then cause dampness in the shoes’ inner lining, causing stinky feet, socks, and shoes. The damp and dark environments are the perfect breeding ground for bacterial and fungal growth – and they are the reason for the smell.

While this issue can be embarrassing, not addressing the issue can cause worse issues. Bacterial or fungal infections can lead to inflammation and pain, or worse, foot ulcers. Foot odor is a problem that occurs to anyone as a natural process of the body, but there are ways to deal with it. The following tips may be helpful, especially for folks who may have hyperhidrosis (excessive sweating), are taking certain medications, or are experiencing hormonal or stress issues:

• Rotate shoes and let them dry out completely each time you wear them. A bit of baking soda or baby powder can help to reduce moisture.
• Wash your feet every day with warm water and soap to reduce the chance of bacterial infection. Dry your feet completely and put on new socks. Never re-wear your socks.
• Inspect your feet daily for any rashes or other signs of bacterial or fungal infections.
• Wear socks whenever you wear closed-toed shoes. If you sweat excessively, bring another pair with you to change socks midday. Moisture-wicking breathable socks are best for preventing dampness in the shoes.
• Ask a podiatrist if you should apply foot sprays or foot powders.

Dr. Jonathan M. Kletz at Texas Foot Works can help you find other ways to deal with your persistent foot odor, as well as see if you have another underlying proble. Make an appointment at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices so that he can assess your needs and get rid of your stinky feet! 

Have you tried yoga yet? In recent years, many have benefitted from practicing Yoga. It is good for the mind and body, helping you to focus, strengthening your muscles, and improving your balance. For your feet in particular, it can be helpful in becoming more aware of two body parts that constantly carry the whole of you around. (Note: If you haven’t practiced yoga before, it is best to begin under the guidance of a Yoga instructor for proper alignment and form to prevent injury.)

Are you ready to connect with your feet and challenge your body to go beyond your daily movements? Try some of these poses to test the flexibility, endurance, and strength of your feet. Remember that pain is not a part of yoga, so only push as far as you are comfortable.

• Tadasana (or Mountain Pose): You may feel like all you are doing is standing. That’s right. This is a standing pose where you feel out how the feet touch the ground and support the entirety of your body. Are you swaying or leaning on one side or the other? Make sure you are balanced. For a challenge, try stretching out your toes wide or lifting them up.
• Tree Pose: Balance on one leg with your other foot against your ankle. How is your balancing foot compensating? Do you put more of the weight on the inner or outer side of your foot (do you over- or under-pronate)? Try to shift the weight evenly on your foot. For a challenge, raise your elevated foot to inside of the knee or thigh, as well as raising your arms above your head, like a tree.
• Hero Pose: This is usually considered an uncomfortable sitting position. However, it is a great way to stretch your ankles and quads. For a challenge, tuck your feet and toes under your bottom, so that your toes are bearing your weight instead of the top of your feet. Where are your pinkies? Did they follow suit? You may have to help tuck them under!

Practicing Yoga often can help your body feel rejuvenated and relaxed from stress or tension. After some of these moves, you may become more aware of your feet and appreciate how much work they do in each pose. You may begin to notice what role your feet play in any activity you do, even when simply walking or standing. Strengthening your feet and improving balance can only improve your feet and ankle health, but pain should not be a part of it. If you notice some pain when you try Yoga or in any other activity, come see our podiatrist, Dr. Jonathan M. Kletz at Texas Foot Works. Make an appointment at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices so that we can assess your needs and treat them properly!