Total Care Podiatry

What is Tinea?

Tinea is a common condition caused by a fungal infection and can affect both the nails and the skin. Skin is commonly affected between the toes, with redness, itching and cracking. Tinea of the nails often presents as a discolouration and thickening of the nail.

How do you get tinea?

Tinea is a contagious condition, and can be spread by direct or indirect contact. Tinea is commonly picked up at public showers, pools or locker rooms where footwear is not worn. As fungus thrives in warm humid environments, so occlusive footwear and sweaty feet commonly contract tinea as the fungus can thrive in a warm wet environment.

How can I treat tinea?

As there are varying types of tinea and a range or treatment options available, it is advisable to speak to your podiatrist about which treatment is best for you.

Tinea is commonly treated with an Antifungal agent, usually a cream, powder or tincture in combination with ongoing nail or skin care.

In addition to using an antifungal agent, it is also advisable to wear cotton socks and ensure you always wear clean socks .  It is also important to wash your feet thoroughly and then dry them properly .

How can I avoid getting tinea?

• Regularly wash feet and dry properly between your toes
• Avoid very tight occlusive footwear especially in hot weather
• Ensure socks, towels and bedding are washed regularly
• Wear thongs to the public pool, showers and changing rooms

For further advice, more information or to discuss treatment options please contact your podiatrist.

Tinea between the toes

WARNING : This information is for educational purposes only and is not intended to replace professional podiatric advice. Treatment will vary between individuals depending upon your diagnosis and presenting complaint. An accurate diagnosis can only be made following personal consultation with a Podiatrist.

What are they?

Sprains and strains are common injuries. Their symptoms are usually graded according to how mild or severe they are.

Sprains often occur in ligaments around a joint, such as your ankle or your knee. However, the joint is not dislocated or fractured. In a minor sprain, some of the fibres within the ligament are stretched. In more serious sprains, the ligament may be torn, either partially or completely. A damaged ligament can cause inflammation, bruising and pain around the affected joint. The most common locations for sprains are the ankle, knee, thumb and wrist.

What causes it?

Sprain:

A sprain occurs when one or more of your ligaments have been stretched, twisted or torn. Ligaments are strong bands of tissue around joints, which connect one bone to another, and help to keep your bones together and stable.

Strain:

Most muscle strains happen if a muscle is:

• Overstretched.
• Forced to tighten (contract) too strongly.

How is it treated?

Most mild to moderate sprains and strains can be treated at home.

Sprains and strains – using PRICE

Healthcare professionals advise that immediate treatment of sprains and strains should follow PRICE therapy. PRICE stands for protection, rest, ice, compression, and elevation.

Sprains and strains – avoiding HARM

For the first 72 hours after a sprain or muscle strain you should avoid HARM. This means you should avoid Heat, Alcohol, Running, Massage.

Sprains – moving the injured joint

Healthcare professionals advise that you should not immobilise your injured joint and should not stop moving completely. As soon as the pain allows you to move your joint, you should start doing flexibility (range of motion) exercises. Your GP can give you information and advice about the exercises that will be suitable for you.

Treating pain

If you experience pain from a strain or sprain paracetamol is the first type of painkiller that is recommended. Oral non-steroidal anti-inflammatory drugs (NSAIDs) can also help to reduce swelling and inflammation. However, NSAIDs should only be considered for use 48 hours after the injury has occurred because if they are used before this time they may adversely affect the healing process. Your GP may also prescribe an NSAID cream or gel such as ibuprofen or ketoprofen to help treat pain.

Recovery

Following a sprain or a strain, the length of time that it will take for you to recover will depend on how severe the injury is.

Depending on its severity after an ankle sprain you will probably be able to walk within 1-2 weeks after the injury. You may be able to use your ankle fully after 6-8 weeks and you will probably be able to return to sporting activities after 8-12 weeks.

What is it?

A neuroma refers to the thickening or enlargement of nerve tissue, which is often caused by irritation or compression of the nerve. This compression causes swelling in the nerve and can lead to permanent nerve damage.

A Joplin’s Neuroma is an entrapment of the nerve travelling along the bottom and inside area of the big toe.

A Morton’s Neuroma causes pain in the ball of the foot that shoots out to the 3^rd and 4^th toes. The 2^nd and 3^rd toes can also be affected. The pain is typically worse when standing an walking and relieved by rest. Discomfort may be felt as a burning pain, deep achy pain, constant burning, radiating pain, electrical pain, or numbness. Others may describe the sensation of feeling as though their sock is bunched up under the ball of their foot or feeling like they’re walking on a lump or a ball.

What causes them?

A Joplin’s Neuroma may be caused by abnormal pronation, or may be associated with a bunion formation.

The exact cause of a Morton’s neuroma isn’t always known, although a number of problems can contribute to the formation of a neuroma.

High heels, particularly those over 5cm (2″), or shoes with constricting, pointed, or tight toe boxes can cause compression (for this reason, women tend to suffer from a Morton’s neuroma more often than men).

Conditions such as a high-arched or flat foot, bunions and hammer toes can lead to a neuroma being formed. These foot types can lead to instability around the toe joints, which can cause the beginnings of a neuroma.

Other causes include sporting activities, such as running or racquet sports, which can involve repetitive irritation to the ball of the foot.

How are they treated?

The treatment options for a Morton’s neuroma can differ according to how long you’ve had the condition and its severity. Identifying the neuroma in its early stages will help to avoid surgery.

The most important action is correct diagnosis ususally requiring a diagnostic ultrasound to differentiate a neuroma from other conditions that can produce similar symptoms.

Early treatments will concentrate on trying to relieve and reduce pressure on the area around the neuroma. This may consist of:

1. A simple change in the style of shoes you normally wear. Wide-toed shoes may be recommended.
2. Padding to provide support for the arch of the foot may be advised to take pressure away from the nerve.
3. Anti-inflammatory drugs (NSAIDs) and a course of steroid injections can help ease acute pain and inflammation.
4. Orthotics will help the foot to function so that the pressure is in the correct structure at the proper timinds, relieve abnormal stress on the affected area.
5. If the neuroma is small, cortisone injections or repeated injections of alcohol can also be beneficial.

In more severe cases, where early treatment options haven’t worked, surgical options may be considered. Surgery to remove the inflamed and enlarged nerve often takes up to 30 minutes and can be performed on an outpatient basis.Recovery generally takes less than four weeks and surgery is successful in 80% of cases.

WARNING : This information is for educational purposes only and is not intended to replace professional podiatric advice. Treatment will vary between individuals depending upon your diagnosis and presenting complaint. An accurate diagnosis can only be made following personal consultation with a Podiatrist.

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Posted: Aug. 30, 2009

HARVARD MEDICAL SCHOOL ADVISER:

QUESTION: My teenage daughters have been wearing flip-flops all summer. These sandals don’t seem to provide any support, and I’m worried that they might be harming their feet. My girls think my concern is misplaced. Who’s right?

ANSWER: Flip-flops are named for the sound they make when you walk in them. But if your daughters keep wearing them all the time, they could be saying, “Ouch! Ouch!” with every step before long.

This isn’t just a matter of opinion. Researchers at Auburn University have found that wearing flip-flops alters the way people walk, changing the gait in subtle ways that can lead to serious sole, heel and ankle problems. They presented their findings at the annual meeting of the American College of Sports Medicine last year.

The researchers videotaped 39 volunteers wearing flip-flops and saw that they scrunched up their toes to keep the flip-flops on their feet when the heel lifted in the air.

This motion stretches the plantar fascia, the tough band of connective tissue that runs along the bottom of the foot. The plantar fascia starts at the heel bone and divides into five bands, with one running to each toe. It also supports the arch of the foot and helps the big toe carry the body’s weight as you push off during a normal stride.

When the plantar fascia and plantar muscles get stretched out, the result is inflammation, pain, tired feet and sometimes heel spurs. These were the very symptoms that students who wore flip-flops all summer reported when they returned to Auburn in the fall. An entire summer of flip-flop wearing had taken its toll.

The research team also found that the gaits of the volunteers changed over the course of the study. Their strides were shorter, and their ankles were turned in slightly, perhaps to help keep their flip-flops from falling off. The altered gait, the researchers speculated, could cause long-term ankle and hip problems.

More research is needed to confirm this small study, but its findings make sense.

In any case, wearing flip-flops occasionally will not harm your daughters’ feet. But they and millions of other people have started wearing them all summer long. Perhaps that’s because flip-flops are comfortable (at least in the short run), keep feet cool and are so easy to put on.

Sandals with straps at the ankle are a healthier choice, however, because your feet and toes don’t need to clench and grab to keep the sandals on.

If your daughters still insist on wearing flip-flops during the last few weeks of summer, you might have them try ones made by Fitflops or Chaco. They have thicker soles, good arch supports and deep heel cups that hold the foot and help with shock absorption. They’ve been endorsed by the American Podiatric Medical Association.

A quick trip to any shoe store will prove that flip-flops are in style right now.

But manufacturers also make footwear with good arch and heel support.

Shop with your daughters and point out these qualities. Together, you’re sure to find a few pairs of shoes that are both healthy and fashionable.