So what keeps us in business anyway?
People being people. We don’t always do what is right and healthy for us. We naturally take for granted what our bodies can do and how good they feel most of the time. We have an accident. We start to test ourselves and try to do things we haven’t done before. We get distracted by life and stop taking care of ourselves. Maybe we just started getting older. Our bodies don’t feel like they used to and now we have pain and we wish we could turn back the hands of time and avoid that pain. Well, unfortunately that isn’t possible. So now what? Don’t despair! Don’t be complacent either.
If you ended up with pain, whether it be from an injury or you have developed heel pain, there are a few key things to remember and a couple of simple rules to abide by. Rules, rules, rules – I know, you don’t want to have restrictions. But to gain the freedom you once had (that being, enjoying your life and not limping around/taking a pile of motrin every day (or may nuprin since it’s little yellow and different…do they still make that? Anyway, I digress)) you have to recognize and address the pain you have. Especially as we get older, that pain doesn’t just go away. In fact, pain is a gift.
Think about this for a minute…Something bad happens. You fell down in your garage putting away the kids’ bikes and toys. When I say you fell down, you fell down. All the way. Your foot turned in and your hip hit the concrete. Now. Imagine that nothing in the world has changed except that now you don’t have pain in your life. So, you get up, you walk into the house and go on about your day. Sure, it sounds like it might be better to not have pain. You wouldn’t get mad at your kids for leaving things out because you still feel good. But I said nothing but pain changes. So your foot swells up. It bruises over the course of the next day and you can’t put your shoe on. But it doesn’t hurt. So you pick out a different shoe and keep on walking and getting things done. Then a couple days have passed and you don’t have pain, but now you are falling down several times a day. A week passes and now you physically can’t stand. Your foot doesn’t hurt. It looks god awful, but it doesn’t hurt. So what’s happening here?
Of course this is an extreme example, but the point is important. If you fall down and tear through the ligaments in your ankle, they can’t effectively hold your foot on your ankle anymore. Wouldn’t you like to be aware of this before a week later when now with this instability and lack of rest, your ankle bones have developed some fractures because you have worn through your tendons too? There is actually a condition called Charcot neuroarthropathy (sounds like shark-O) where a similar scenario plays out. The foot structure actually breaks down due to multiple fractures and dislocations and causes an inverted arch appearance which leads to pressure on areas of the foot where it shouldn’t be. Open sores can develop and lead to infection, hospitalization, surgery and even amputation. This condition occurs in patient’s who have lost sensation in their feet. There’s a lot more too it than just not having pain, but it’s a great example of what can happen – the amount of destruction that can occur – when you don’t have pain.
Pain is there to tell us something.
In most cases, it is telling us that something is wrong and your body (perhaps with some assistance) needs to fix it. This pain makes you not want to get up. It makes you walk differently, which over time leads to other areas of the body becoming aggravated and painful. It stops you from doing what you love. BUT if we actually listened to our body when we first have that pain and you have the guidance of someone in town who sees foot and ankle conditions all the time (hint, hint) that pain will subside as your condition improves and you can get back to what you love. Without pain. Without instability. With a whole lot less likelihood that you are going to have that pain come back again. A little bit of love and attention to a foot condition when applied early and consistently leads to the best outcome.
So, back to the real world.
You have pain. Knowing what is causing the pain is the first step in properly addressing it. That’s where we come in. Now yes, in some cases, you ‘tweak’ something and you do some icing, resting, compression and elevation. Maybe you just overdid it and you gave yourself the rest you needed and did some icing. If you can walk on your foot without difficulty (you just feel/notice that it hurts) and your condition improves to where you forgot anything even happened within a couple of days (and I mean a couple as in 2 or maybe 3), you may be just fine on your own. Our criteria for a sooner visit is if you cannot bear weight on your foot. Even excessive bruising and swelling should be evaluated by a professional. And of course, if you rest, ice, compress and elevate and you still feel that pain after 2 to 3 days-or it’s worsening-make an appointment.
In order to find out what is causing the pain or what is “wrong” at the root of all of it, a complete foot and ankle exam is needed. As podiatrists, we are specially trained and experienced to determine what structures are damaged/affected when you have pain. The answers lie several bits of information we obtain during a regular office visit. First, the narrative you provide to us about the issue sets the stage for possible conditions causing your pain. Where your pain is, how it feels, the intensity and what types of things make it worse or better and how it came on are part of this. Secondly, the physical exam where we evaluate the structures of your feet and ankles gives us more objective information. We compare one side to the other and we perform special tests to narrow down the possible diagnoses. And since our very expensive education unfortunately did NOT include obtaining x-ray vision, we rely on x-ray images to view the bones and joints within the foot for abnormalities. At our office, we have digital x-ray available.
What’s so special about our x-ray? For one thing, because our office evaluates only foot and ankle, our x-ray machine is smaller and therefore emits less radiation than the large counterparts at the hospitals, urgent care facilities, emergency rooms, etc. The other awesome thing about digital x-ray is that we get the pictures in a matter of seconds. You walk/hobble/crutch your way to our xray area (not across the halls of a hospital), the pictures are taken by our highly trained staff, and within minutes, we can come into the room and in many cases even show you the images right on the spot.
When we look at x-rays we can confirm or deny fractures and dislocations of bones.
Some of these things are not evident on the clinical exam and with x-rays, even if we already know the bone is fractured, we are able to classify the fracture which helps to determine the appropriate course of care. In the case where an injury has not occurred, the x-rays we take are weightbearing (a long as tolerable). This provides further information about foot structure that helps us to determine where the stress on a given structure is coming from. Then that information when combined with your physical exam helps us to determine what type of support may be needed in the long run. Because, lets admit it, we don’t want this pain to come back again. And the awesome news is that short of outright injuries to the feet and ankles, most conditions are avoidable. Overuse of a tendon or ligament is most often due to a lack of support for a given foot structure. Custom orthotics help to balance to foot to come as close as possible to having a neutral foot where all the tendons, joints, ligaments work harmoniously rather than there being a couple areas that experience more stress or strain.
What else is great about our office?
We have nearly everything we need to take care of injuries and foot conditions on the spot. We have had several patients come to us AFTER they’ve been to the ER and perhaps were given a super cute postop shoe. This is about the best that the ER can do, unless they put you in a splint. Our office has walking boots, we can apply casts and splints, we have those cute shoes too, and we have the best ankle braces available. We have all of these things because our patients are VIP. We want to provide the very best care for you to ensure you have the most seamless recovery as possible. We take time to train our staff in the operations of the office, their specific duties and responsibilities and also the conditions we treat at the office. They are our extra set of hands – an extension of our doctors – and help our office to run more efficiently so that you have the best possible experience. Our non-clinical staff assists in verifying insurance benefits and helps ensure our patients understand their benefits.
So, in summary, don’t live with foot pain. Don’t even assume that the pain you have will go away on its own. Our bodies are amazing. Their ability to heal is the most fascinating thing about our job. But we have to provide what they need to do it. Be smart and when your foot hurts, give it some rest. Ice the area to reduce swelling and pain. Put some light compression on it to mediate any swelling you can. Elevate the area to keep the swelling from building up. If you can’t walk on your foot because of the pain or if you have suffered an injury that caused significant bruising or swelling, call our office. We have same day appointments for these types of conditions. If you have a nagging condition, seek treatment sooner rather than later to give yourself the best chance of recovery.