March Articles 2014

Causes, Symptoms, and Treatment of Poor Blood Circulation in the Feet

Poor blood circulation in the feet and legs is often caused by peripheral artery disease (PAD), which is usually the result of a build up of plaque in the arteries. Plaque build up, or atherosclerosis, can be the result of excess calcium and cholesterol in the bloodstream, which restricts how much blood can flow through arteries. Reduced blood flow to a certain area of the body severely limits the amount of oxygen and nutrients that part of the body receives, causing degeneration in the muscles and other tissues. Sometimes, poor blood circulation in the feet and legs can be caused by other conditions, such as damage to or inflammation of blood vessels, known as vasculitis.


The lack of oxygen and nutrients caused by poor blood circulation can restrict muscle growth and development, as well as cause muscle pain and cramps, weakness, and stiffness. Other common symptoms include numbness in the legs and feet, skin discoloration in the affected limbs, slower nail and hair growth, and erectile dysfunction in men. In more severe cases of PAD, pain can be present even when a person isn't exercising, and may range from mildly uncomfortable to completely debilitating.

Poor blood circulation in the feet and legs is more common in those who are overweight or obese, have diabetes, high blood pressure, high cholesterol, who smoke, or who have a family history of PAD or related conditions (heart attack, stroke, etc.). Diabetes and smoking place a person at greatest risk for developing poor blood circulation, although advanced age (over 50) can also increase risk.

If you are experiencing poor blood circulation in the feet and legs caused by PAD, it is important to make changes to your lifestyle in order to reduce your risk of experiencing a heart attack or stroke caused by this condition. If you smoke, quit completely -- this will increase the amount of oxygen in your bloodstream. Exercising and reducing the saturated fats in your diet (which come from fatty meats, fried foods, whole milk, etc.) can make a difference in improving blood circulation in feet. It is also important to avoid developing influenza and to carefully control your blood sugar if you have diabetes.

Your doctor may recommend combining lifestyle changes with a prescription medication regimen to improve blood circulation. The most commonly-used medications for PAD are called statins and work by blocking the amount of enzymes in your body that produce cholesterol. They are known by the brand names Zocor, Lipitor, Crestor, and others.


Stretching Your Feet

Debilitating foot pain is a problem for many people. But just as stretching the torso can help alleviate back pain, stretching the feet can also mend existing problems and prevent future ones.


The feet carry the entire weight of the human body all day and can get easily strained from overexertion. Persistent sharp pain and cramping in the feet are common problems. Foot pain and problems can be due to any number of causes, and in many cases pain may be eased without medication or doctor visits; however, it is always a good idea to rule out any serious medical issues first with a physician.

Stretching may help relax the feet and alleviate pain at any time, but it is especially important before    heavy aerobic exercise to avoid painful cramps or straining muscles in the feet. Stretches should be performed slowly and deliberately without forceful pulling. The stretch should be held for several seconds, and then relaxed.

A great way to stretch out and loosen up the foot muscles while sitting is to cross one leg over the other and pull the toes carefully back without overextending. Start by resting the left ankle on the right knee. With the left hand, gently flex the left foot by pulling back on the toes. Do not pull too hard, just hard enough to feel the stretch in the arch of the foot. Then point the toes of the left foot as far as you can. Rotate the motion of pointing with pulling back on the toes. This should relax and stretch the muscles on the bottom and the top of the foot. Doing this stretch ten to twenty times should bring relief. Repeat the whole process for the other foot by resting the right ankle on the left knee.

A stretch that focuses on the often injured Achilles tendon involves standing, facing a wall, with your arms out and hands flat against the wall. Step back with one foot, keeping it flat against the floor. Move the other leg forward and lean toward the wall. You should feel a stretch through the back of your leg and your Achilles tendon, but do not push yourself too much. Stop when you feel the stretching sensation and hold for 30 seconds. Ten repetitions may be done for each foot.

Stretching the feet is important for athletes or those performing aerobic exercise, but it can also help anyone with foot pain caused by poor footwear, plantar fasciitis, or long hours standing and walking. Individuals who tend to their feet by regular stretching every day should be able to minimize foot pain and prevent new problems from arising.



What To Know About Ankle Injuries

Ankle injuries are a very common injury to the foot. The ankle is the point of connection from the leg and the foot. The joint is the point where the tibia (big leg bone), fibula (small leg bone) and the talus (top of the foot) all meet. These bones are held together by tendons and ligaments. Tendons hold muscles to bone and ligaments hold bones together. An ankle sprain involves the ligaments of the foot.

Ankle sprains occur when the foot is twisted in an unnatural way. While sports injuries have many ankle sprains, other common experiences such as slipping on stairs or walking on uneven ground can result in an ankle sprain. When the foot twists in a way that is not natural, the ligaments will be stretched.

Immediately after an ankle sprain occurs, there will be fluid leakage into the tissues. This causes inflammation and swelling which results in pain. Nerves are sensitized and the increase in fluids puts additional pressure on the nerves which causes an increase in pain. When this occurs, heavy blood flow to the injured area will often result in heat, making swollen ankles warm to the touch.

Severe pain, deformity of the bone, loss of feeling, and inability to walk for even minimal amounts of time are indications that you need to seek immediate medical attention. The ligaments that hold the foot bones together might become too stretched which can cause the bone to feel out of place or dislocated.  A podiatrist will provide an examination to make sure there is feeling present, adequate movement, and that the tendons have not been damaged. If symptoms warrant it, an x-ray will be ordered to determine possible fractures.

One of the first things to do after an ankle injury is to apply ice to the area of injury. The immediate use of ice helps to reduce inflammation, but should not be applied directly to the injured area. Reducing the pressure on the ankle is another key step when treating sprains. This involves elevating the ankle above the level of the heart to reduce the flow of fluids. An elastic bandage may be needed which provides support for the ankle and prevents inflammation through compression.

Limiting motion of the injured ankle will help speed up the recovery. Using a brace or crutch is an effective way to limit motion and promote a speedy recovery. If properly addressed, ankle sprains can heal in a minimal amount of time. There may be some limitation as to movement, however, stretching and rotation of the joint can get it back to prior injury status.



Choosing the Right Running Shoe for Your Foot Type

While running seems like a simple activity, it is actually a complicated movement that puts a lot of stress on the joints, bones and ligaments of the body. Consequently, choosing the right shoe is an important step in increasing performance and decreasing injury risk. You should select running shoes based on your foot type. While other considerations are important, such as trail versus road shoes, your foot type dictates the amount of cushioning, stability and motion control you need. The best way to determine your foot type is to visit a local specialty running shop. Professionals there can measure your arch type, stride and gait and summarize your shoe needs for future reference.

Running shoe design is based on the idea of pronation. Pronation is the natural rolling of your ankle from outside to inside during foot strike. In other words, proper running mechanics involve striking the ground on the outside of your heel and rolling toward your big toe before pushing off again. Pronation is a good thing: it helps your lower extremities absorb shock and store energy. Neutral runners who pronate correctly do not depend on their shoes to correct their form. Neutral runners can select from a large variety of shoes, even minimal or barefoot models. However, runners with problematic foot arches or incorrect form may pronate too much or too little and require specific qualities from their running shoes.

Overpronators run with excessive ankle rolling. Even when standing, severe overpronators exhibit ankles that angle inward. They also tend to have flat feet or bowed legs. Overpronation can cause a plethora of injuries, especially in the knees, ankles and Achilles tendons. If you overpronate, you should select a shoe with extra stability and motion-control. Motion-control shoes are firm and straight; they do not curve at the tip. The lack of flexibility along the midsole prevents the foot from rolling too far inward during your foot strike.

Underpronation, also called supination, is less common than overpronation. Unlike overpronators, underpronators have inflexible feet and high arches. When they land, their feet are unable to roll inward. While this places less rotational stress on the ankles and knees, it prevents any kind of shock absorptions. This additional force can result in fractures, ligament tears and muscle strains as the legs compensate for the impact. Underpronators require shoes with increased cushioning and flexibility. If you underpronate, stability or motion-control shoes may compound the problem by further preventing pronation.



Sport Related Foot And Ankle Injuries

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 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.

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.

Plantar fasciitis is a painful injury. It is inflammation of the plantar fascia, the thick fibrous band of tissue running from the heel to the base of the toes. Left untreated it can lead to a degenerative disease called plantar fasciosis. 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 like foot supports. Surgery is occasionally used as a last resort, but it comes with the risk of nerve damage and infection and often does not stop the pain.

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


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