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Dr. Robert D. Weaver

Dr. Jennifer Zienkowski-Zubel

Blog
Holiday Gout
Protect Your Feet From Cold Temperatures
National Diabetes Month - Tips
National Diabetes Month - Facts
Does your child have smelly feet?
Shoe Shopping Tips for Your Children
Sunscreen on Your Feet?
Tendonitis
Metatarsalgia
Keep Your Child’s Feet in the Game
Common Runners’ Injury: Stress Fractures of the Foot
Five Signs Your Child May Have a Foot Problem
FAQ Regarding Bunions
Winter is Fall Season For Many Clevelanders
Pro Athletes Not the Only Ones at Risk for Achilles Tendon Injuries
Foot Injuries Increase in the Winter Months
Frostbite

Holiday Gout
December 2015

For those people who have experienced a gout attack in the past, or have a family member who has had this condition before, you know how painful and miserable it can be. The holiday season can also be a time which gout attacks can be triggered, and the Holiday Season is upon us and New Year’s Eve is just a few weeks away….So what is gout exactly? And how can I prevent it from happening to me, or someone I care about?

The Holidays

Gout is a disorder that results from the build-up of uric acid crystals in tissues or a joint. It most often affects the joint of the big toe, because the toe is the coolest part of the body and uric acid is sensitive to temperature changes. However, other joints of the body can also be affected by gout.

Changes in diet, including overindulging in certain foods and beverages, can cause a gout attack this time of year because often holiday foods and drinks are rich in purines. Foods and drinks that are high in purines contribute to uric acid build-up. Purines are converted to uric acid in the body.

Symptoms of a Gout Attack:

  • Intense pain that comes on suddenly – often in the middle of the night or upon rising in the morning
  • Signs of inflammation such as redness, swelling, and warmth over the joint.
  • Very painful to touch, even light touch like the weight of bed sheets

How is Gout Diagnosed by Your Podiatrist?

  • Personal and family medical history
  • Examination of the affected joint
  • Laboratory tests to check inflammation and uric acid levels
  • X-rays to determine if the inflammation is caused by something other than gout

How Can You Avoid A Gout Attack?

  • Avoid purine-rich items such as shellfish (shrimp, crab, etc.), organ meats (kidney, liver, etc.), red meat, red wine, beer and other alcohol.
  • Drink plenty of water and other fluids each day. Avoid alcoholic beverages, which can cause dehydration.

How Do You Treat A Gout Attack?

  • Gout pain and inflammation can be treated with Prescription medications (like Indocin, Colchicine, or steroids) or by injections of steroids.
  • Long term uric acid build up can be controlled by Prescription medications such as Allopurinol or Uloric
  • Dietary changes: avoiding food high in purines
  • Increasing consumption of water

The symptoms of gout and the inflammatory process usually resolve in 3 to10 days with treatment. If gout symptoms continue despite the initial treatment, or if repeated attacks occur, treatment with maintenance medications may be needed.

Enjoy the Holidays this festive time of year, but if you have a history of gout, remember to enjoy in moderation, otherwise this time of year may not be so festive for you!

If you or a loved one fall victim to gout, please give our office a call, 440-442-3113. We are here to help!


Protect Your Feet From Cold Temperatures
December 2015

It’s December and temperatures are dropping, so you better start bundling up. This doesn’t just mean putting on a puffy coat and gloves – you need to remember to show your feet some warmth too. The dry winter air and cold temperatures are hard on your feet. For those who crave to go out in the freezing temperatures to ski, snow board or skate, you need to be careful. You don’t need to be afraid to go out in the winter weather – just follow these tips to protect your feet from the cold temperatures:

Warm Boots for Winter

Make sure the shoe or boot fits

This rule really applies all year round. Do not squeeze your feet into boots that are too small. Make sure you have winter footwear that’s the right size and width to avoid crowding, discomfort and blister formation.

Keep your feet warm and dry

Staying active outdoors during the cold winter months can be pretty difficult. Your feet need to stay warm, but trapping heat can lead to moisture build-up. To avoid this, our practice recommends wearing a light synthetic sock to keep moisture away from the feet then a thicker wool outer sock where moisture can be absorbed and evaporated to the outside. This is especially important for winter sports such as skiing, snowboarding and ice skating because stiff boots won’t allow evaporation.

Moisturize

Feet easily become dry and cracked during the winter. You can avoid any skin discomfort by moisturizing daily with creams and lotions with rich ingredients such as shea butter or coconut oil.

Keep your feet manicured

Just because you’re wearing boots this season and have put your sandals in the the closet for the winter doesn’t mean that you should ignore your feet until you pull your sandals back out again. You should keep your toenails trimmed to prevent ingrown toenails and exfoliate to remove excess skin.


National Diabetes Month - Tips
November 2015

As discussed in our latest blog, according to the American Diabetes Association, about 15.7 million people (5.9 percent of the United States population) have diabetes. Nervous system damage (also called neuropathy) affects about 60 to 70 percent of people with diabetes and is a major complication that may cause diabetics to lose feeling in their feet or hands. With a diabetic foot, a wound as small as a blister from wearing a shoe that’s too tight can cause a lot of damage, therefore, listed below is daily advice to follow:

  • Always keep your feet warm.
  • Don’t get your feet wet in snow or rain.
  • Don’t put your feet on radiators or in front of the fireplace.
  • Don’t smoke or sit cross-legged. Both decrease blood supply to your feet.
  • Don’t soak your feet.
  • Don’t use antiseptic solutions, drugstore medications, heating pads or sharp instruments on your feet.
  • Trim your toenails straight across. Avoid cutting the corners. Use a nail file or emery board. If you find an ingrown toenail, contact our office.
  • Use quality lotion to keep the skin of your feet soft and moist, but don’t put any lotion between your toes.
  • Wash your feet every day with mild soap and warm water.
  • Wear loose socks to bed.
  • Wear warm socks and shoes in winter.
  • When drying your feet, pat each foot with a towel and be careful between your toes.
  • Buy shoes that are comfortable without a “breaking in” period. Check how your shoe fits in width, length, back, bottom of heel, and sole. Avoid pointed-toe styles and high heels. Try to get shoes made with leather upper material and deep toe boxes. Wear new shoes for only two hours or less at a time. Don’t wear the same pair every day. Inspect the inside of each shoe before putting it on.
  • Don’t lace your shoes too tightly or loosely.
  • Choose socks and stockings carefully. Wear clean, dry socks every day. Avoid socks with holes or wrinkles. Thin cotton socks are more absorbent for summer wear. Avoid stockings with elastic tops.

When your feet become numb, they are at risk for deformity. One way this happens is through formation of an ulcer. Ulcers also known as open sores may become infected. Another way is a bone condition referred to as Charcot (pronounced “sharko”) deformity. This is one of the most serious foot problems you can face as a diabetic. This condition causes the shape of your foot to change through the bones of your foot fracturing and disintegrating, as you continue to walk because it doesn’t hurt. Diabetic foot ulcers and early phases of Charcot fractures can be treated conservatively at our office. Please do not allow either condition to progress past the early phases. We are here to help. Please give our office a call at 440-442-3113.


National Diabetes Month - Facts
November 2015

November is Diabetes Awareness Month and November 14, 2015 has been designated as World Diabetes Day. Are you or your loved a diabetic? If so, now is the time to schedule a yearly diabetic foot check-up.

Diabetes awareness and prevention is very important to podiatrists because a majority of our patients are affected by diabetes. We are here to help because diabetes can have devastating complications, please see below:

  • 29.1 Million Americans have diabetes, 8.1 million are unaware of their disease. Every 19 seconds, someone in the US is diagnosed with diabetes.
    Centers for Disease Control and Prevention. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta, GA: U.S. Department of Health and Human Services, 2014.
  • 25% of people with diabetes will develop foot ulcers. Reoccurance within 5 years is 28-51%
    Reddy, M. Gill, S., Rochon, P. (2006) Preventing Pressure Ulcers: A Systematic Review. JAMA. 296(8): 974-984.
  • 15% of diabetic wounds will progress to amputation
    Frykberg, Robert G. and Rogers, Lee C. “Emerging Evidence on Advanced Wound Care for Diabetic Foot Ulcers.” Proceedings from the Superbones West Conference in Las Vegas, Nevada. October 2010.
  • Foot ulcers precede 85% of lower extremity amputations.
    Reiber, G. Smith, D. Vileikyte, L., Boyko, E., Aguila, M., Lavery, L., Boulton, A. (1999) Causal Pathways for Incident Lower-Extremity Ulcers in Patients with Diabetes from Two Settings. Diabetes Care. 22(1): 157-162.
  • Every hour, ten Americans undergo amputation due to diabetes.
    http://www.house.gov/degette/diabetes/facts.shtml Accessed December 2013
  • In 2012, the total cost of diagnosed diabetes was $245 billion ($176 billion for direct medical cost and $69 billion for indirect costs like disability, work loss and premature mortality).
    Centers for Disease Control and Prevention. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta, GA: U.S. Department of Health and Human Services, 2014.

The best way to prevent diabetic complications is to check your feet daily and keep regularly scheduled appointments with a podiatrist. Please give our office a call for an appointment, 440-442-3113.


Does your child have smelly feet?
October 2015

Does your child have smelly feet? Is your child afraid to take off their shoes while at a friend's house due to fear of embarrassment? If so, we are here to help. First, use antibacterial soap to clean your child's feet to address bacteria, which is a common cause of odor, daily. Additionally, be sure to alternate your child's shoes and have them wear fresh socks daily, as this can help to remove the presence of unpleasant smells.

Sweat is another main cause of foot odor. Make sure the shoes are washed and cleaned regularly, and double check shoe sizes to be sure that they are not too tight on your child's feet. If smells continue to be stubborn, please call our office, 440-442-3113, for a consultation.

Keeping Children's Feet Healthy

Having healthy feet in childhood can help prevent medical problems later in life. As children grow, their feet require different types of care from birth to school-age.

Although babies do not walk yet, it is still very important to take care of their feet.

  • Avoid putting tight shoes or socks on his or her feet
  • Allow the baby to stretch and kick his or her feet to feel comfortable

As a toddler, kids are now on the move and begin to develop differently. At this age toddlers are getting a feel for walking, so don’t be alarmed if your toddler is unsteady or ‘walks funny’. Be sure the child wears comfortable and protective shoes so that they can grow into their feet properly.

As your child gets older, it is important to teach them how to take care of their feet

  • Show them proper hygiene to prevent infections such as fungus
  • Be watchful of any pain or injury
  • Have all injuries checked by a doctor as soon as possible
  • Comfortable, protective shoes should always be worn, especially at play

For more information about Keeping Children’s Feet Healthy, please visit our website and/or give our office a call, 440-442-3113, for an appointment. We are here to help!


Shoe Shopping Tips for Your Children
August 2015

Summer is drawing to a close and kids will be returning back to school. If your back-to-school shopping has not started already, it soon will. Picking out new clothes, including footwear, is a big part of that, so this is a good time to share some shoe shopping tips for your children.

Bring your child shoe shopping with you. Depending on age, children’s shoe sizes can change every couple of months as they grow. Additionally, every shoe is going to fit differently and this means the best practice is to have your child try on footwear in advance of purchasing them.

Go shopping later in the day. Feet expand during the course of the day, so a pair that fits in the morning can be tight by the time night falls. This problem is easily avoided by simply heading out a little later to ensure the best possible fit throughout the entire day.

Fit the pair to the larger foot. Feet are rarely the exact same size, so have both measured and find footwear based on the larger of the two. When you do, make sure there is a thumb’s width of space between the largest toe on that foot and the front of the shoe and also that the heel is properly cradled.

Don’t plan on a “breaking-in” period. If a pair of shoes are not immediately comfortable, do not purchase them.

The proper footwear can reduce the risk of foot injuries and conditions, but keep in mind that few are 100%avoidable. If your child needs expert care for any foot or ankle issue, please give our office a call. We are here to help!


Sunscreen on Your Feet?
June 2015

When at the pool or lake we all lather up with sun screen to protect our skin from the harmful rays of the sun. But do we remember to apply sunscreen to our feet?

Many don’t realize skin cancer can occur on the feet from unprotected sun exposure, and overlook applying sunscreen to the area. Skin cancer of the foot is prevalent and can even be fatal if not caught early.

While all types of skin cancer, including squamous cell and basal cell carcinoma, can be found on the foot, the most common is the most serious form, melanoma. Symptoms can be as subtle as an abnormal-looking mole or freckle found anywhere on the foot, and often go unnoticed without routine foot exams.

Early diagnosis is key to effective treatment for the condition. But because people aren’t looking for the early warning signs or taking the same precautions they do for other areas of the body, often times skin cancer in this region is not diagnosed until later stages.

We advise our patients to regularly inspect their feet, including the soles, in between their toes and even under their toenails, for any changing moles or spots and to have any suspicious areas promptly examined by our office.

If you or someone who know has an abnormal lesion on their foot and/or ankle, please contact our office, 440-442-3113, for an appointment.


Tendonitis
May 2015

Tendonitis, or tendinitis, is inflammation, irritation and swelling that affects a tendon. As you would expect, achilles tendinitis is inflammation of the tendon that links the two calf muscles at the back of the leg to the heel bone. The achilles tendon is the largest tendon in your body. It is used for walking, jumping and running. If you suffer from achilles tendinitis, you have likely experienced pain and inflammation at the bottom of your foot. Other symptoms include moderate to severe pain along the back of your leg, pain that worsens with increased activity, tightness of the tendon, thickening of the tendon, or a bone spur. Achilles tendinitis can be caused by excessive use or repetitive motion placing stress on the achilles tendon, such as in running and/or jumping rope.

For people living with achilles tendinitis, here are 3 non-surgical tips to help reduce or stop your symptoms:

  1. Rest: Resting is the first thing you should do when you start experiencing pain. Pain is an indication that something is wrong; therefore, it should not be ignored. Decrease or stop any activity that is worsening your symptoms. For example, if you are someone who regularly participates in high-impact exercises (running, jumping rope, jumping jacks, aerobics) that place additional stress on your achilles tendon, switch to low-impact exercises. Swimming, biking, walking, and rowing are great low-impact exercises that put minimal stress on the achilles tendon.
  2. Ice:Ice is another easy treatment because it can help reduce swelling, inflammation, and pain. Place an ice pack on the area of the achilles that is bothering you for up to 15 minutes a session. Be sure to remove the ice pack before numbness occurs. An ice pack can be used two to three times a day.
  3. Calf Exercises:Not all exercises increase stress on the achilles tendon. Calf stretching exercises can decrease stress and strain on the achilles tendon and strengthen the calf muscles. To start your calf exercises, brace yourself by placing both hands on a wall. Gently stretch out one leg behind you comfortably with your foot still flat on the floor. Put your opposite leg in front of you, ensuring your knee is slightly bent. Push your hips forward towards the wall in front of you and hold for 10 seconds. You should feel a moderate pull in your calf. Repeat 10 times on each leg.

If you live in the Cleveland area and your pain persists after using these tips, you should contact our office to schedule an appointment. We are here to help!


Metatarsalgia
April 2015

Metatarsalgia denotes a common foot condition characterized by pain and inflammation of the joints and bones of the ball of the foot - the area just before the toes, also called the metatarsal region.

Symptoms of metatarsalgia can develop suddenly, especially after an increase in exercise or high-impact activities, but normally develops over time. Common symptoms of metatarsalgia include:

  • Sharp, aching or burning pain in the ball of your foot -- the part of the sole just behind the toes
  • Pain that intensifies when you stand, walk or run
  • Pain that radiates from the balls of the feet into the toes
  • Numbness or tingling in the toes
  • Pain that increases when walking barefoot

Sometimes a single factor can trigger metatarsalgia. More often, multiple factors contribute to the pain, including:

  • Over-training or Over-activity. Extensive training and high-impact sports, especially running, places an abnormal amount of stress on the balls of the feet, causingirritation, inflammation and pain.
  • Other foot disorders. High arches, hammertoes, bunions, stress fractures and Morton's neuroma can all trigger metatarsalgia symptoms.
  • Poor-fitting footwear. High heels, narrow-toed shoes and shoes without adequate padding can all contribute to metatarsal problems.
  • Excess weight. Extra weight places excess pressure on your metatarsals.
  • Aging. The fat pads on the metatarsals thin out as a person ages, diminishing the ability of the metatarsal bones to protect themselves.

Although generally not serious, metatarsalgia can disrupt your day to day activities, and when left untreated can lead to additional pain in your unaffected foot, back or hips.

Treatment to eliminate metatarsalgia symptoms can be as simple as resting, icing the affected area and wearing proper-fitting shoes to significantly reduce swelling and ease pain. When conservative treatments are not effective and pain persists please contact our office for an appointment.


Keep Your Child’s Feet in the Game
April 2015

Spring soccer season will soon be in full swing; don’t let your child be sidelined by toe pain. Tight or hand me-down cleats combined with repetitive kicking can lead to painful ingrown toenails. It’s a common condition among all age groups, especially children. A nail becomes ingrown when its corners or sides grow into the. skin of the toe, causing discomfort, redness, swelling and sometimes infection.

While tight shoes or socks and incorrect nail trimming are the usually cause of ingrown toenails, sometimes children inherit the tendency for nails to curve. You can help prevent this painful condition by following a few simple tips:

  • Make sure children’s sports and day-to-day shoes fit properly. Improper shoe width often contributes to ingrown toenails. It is important for the widest part of the shoe to match the widest part of your child’s foot.
  • Teach children how to trim their toenails properly. Toenails should be trimmed straight across and not cut too short.
  • Make it a habit to check your children’s feet starting at a young age. Oftentimes kids hide their foot pain from their parents.

If your child develops an ingrown nail, the only permanent cure is with a minor procedure performed at our office. Don’t ever try to dig the nail out or cut it off yourself. These dangerous “bathroom surgeries” carry a high risk for infection.

As always, we are here to provide care for your entire family. If you have questions about your child’s feet, don’t hesitate to contact our office, 440-442-3113.


Common Runners’ Injury: Stress Fractures of the Foot
March 2015

Stress fractures of the foot are becoming more common in runners, especially first-time marathoners.

The growing popularity of marathons among beginning runners has contributed to the increase in repetitive stress injuries, including stress fractures of the foot. Often, first-time marathoners enter a race with little or improper long-distance training. The lack of experience coupled with the repetitive impact placed on the feet during the run can produce enough stress to cause hairline breaks in the bones of the foot.

Runners who increase their mileage too quickly or change to a more intense phase of training may be more susceptible to a stress fracture due to the increased force placed on the bones. A general rule of thumb for runners is to increase the mileage by no more than 10 percent each week. Runners who are training also need to have adequate rest time in between runs to help decrease the risk of a fracture.

Runners at all levels of experience are also at higher risk for stress fractures if they wear improper shoes while running or training, suffer from flat foot or other foot deformities, or have osteoporosis. Signs of a stress fracture can include pain, swelling, redness and possibly bruising of the area.

Stress fractures can occur anywhere in the foot and can eventually lead to a complete break of the bone if left untreated. Early diagnosis and treatment are important to ensure proper healing.

If a break is suspected, runners must immediately follow the RICE protocol—Rest, Ice, Compression and Elevation. If pain and swelling last longer than a few days, an appointment for an x-ray and diagnosis is in order.

In most cases, treatment includes rest and immobilization with casting of the foot. Surgery may be required in certain instances to repair and stabilize a stress fracture that has progressed into a full fracture.

Runners can take action to prevent repetitive stress injuries in their feet by wearing supportive athletic shoes and slowly building up their activity levels according to their abilities. If a runner suffers from abnormal mechanics in the foot, such as over pronation or hypermobility, custom orthotics can also be helpful to prevent these injuries.

If you suspect you have a foot injury or fracture, please call our office, for evaluation and treatment, 440-442-3113.


Five Signs Your Child May Have a Foot Problem
March 2015

Foot and ankle problems in children often go unnoticed. Signs and symptoms can be subtle, and sometimes children can’t explain what’s wrong. But it’s important to protect growing feet and have problems checked out early.

Below are five warning signs every parent should watch for:

  1. Your Kids Can’t Keep Up with Their Peers
    If children lag behind in sports or backyard play, it may be because their feet or legs are tired. Fatigue is common when children have flat feet. The muscles in the feet and legs tire easily because the feet are not functioning as well as they should.

  2. Children Voluntarily Withdraw from Activities they Usually Enjoy
    If they are reluctant to participate, it may be due to heel pain — a problem often seen in children between the ages of 8 and 14. Repetitive stress from sports may cause muscle strain and inflammation of the growth plate, a weak area at the back of a child’s heel.

  3. They Don’t Want to Show You Their Feet
    Children may feel pain or notice a change in the appearance of their feet or nails but don’t tell their parents because they fear a trip to the doctor’s office. Therefore, parents should make it a habit to inspect their child’s feet starting at a young age. Look for any changes such as calluses, growths, skin discoloration, or redness and swelling around the toenails.

  4. Your Child Often Trips and Falls
    Repeated clumsiness may be a sign of in-toeing, balance problems or neuromuscular conditions.

  5. The Child Complains of Pain
    It is never normal for a child to have foot pain. Injuries may seem minor, but if pain or swelling last more than a few days, have your child’s foot examined.

If you’ve noticed any of these signs in your children, please call our office for an assessment.



Frequently Asked Questions Regarding Bunions
March 2015

Here are some frequently asked questions and answers about bunions and their treatment provided by the American College of Foot and Ankle Surgeons.

  1. Are bunions hereditary?
    Bunions are most often caused by an inherited faulty mechanic structure of the foot. It is not the bunion itself that is inherited, but certain foot types that make a person prone to developing a bunion.

  2. Do over-the-counter pads and splints really work?
    Pads placed over the area of the bunion may help minimize pain from a bunion. However, padding and splinting cannot reverse a bunion deformity.

  3. Will my bunion get worse?
    Because bunions are progressive, they don't go away, and will usually get worse over time. But not all cases are alike. Some bunions progress more rapidly than others.

  4. Is it better to have it fixed now, or should I wait?
    When the pain of a bunion interferes with daily activities, it's time to discuss surgical options with your foot and ankle surgeon. Together you can decide if surgery is best for you.

  5. How can I avoid surgery?
    Sometimes observation of the bunion is all that's needed. A periodic office evaluation and x-ray examination can determine if your bunion deformity is advancing, thereby reducing your chance of irreversible damage to the joint. In many other cases, however, some type of treatment is needed, such as changes in shoes, padding, activity modifications, pain medications, icing, injection therapy, and/or orthotic devices. When the pain of a bunion interferes with daily activities, it's time to discuss surgical options with your foot and ankle surgeon. Together you can decide if surgery is best for you.

  6. Will my insurance company pay for the surgery?
    In most cases, yes, however contact your insurance to verify coverage.

  7. Is the surgery painful?
    The amount of pain experienced after bunion surgery is different from one person to the next. Most patients will experience discomfort for three to five days. If you closely follow your foot and ankle surgeon's instructions, you can help minimize pain and swelling after your bunion surgery.

  8. What type of anesthesia is involved?
    Most bunion surgeries involve local anesthesia with intravenous sedation. That means your foot will be numb and you will be given medications to relax you during the procedure.

  9. If I need surgery, how long will recovery take?
    The length of the recovery period will vary, depending on the procedure or procedures performed. Your foot and ankle surgeon will provide you with detailed information about your recovery.

  10. Will I be able to walk normally, or even exercise and run, after healing from bunion surgery?
    In most cases, yes.

  11. How soon can I walk after surgery?
    It depends on your bunion and the surgical procedure selected for you.

  12. How soon can I go back to work after surgery?
    The length of the recovery period will vary, depending on the procedure or procedures performed.

  13. How soon can I drive after surgery?
    The length of the recovery period will vary, depending on the procedure or procedures performed.

  14. Can the bunion come back?
    Yes, there is a risk for bunion recurrence in some cases. Patients can help prevent this by following their doctor's instructions to wear arch supports or orthotics in their shoe.

  15. If screws or plates are implanted in my foot to correct my bunion, will they set off metal detectors?
    Not usually. It can depend on the device chosen for your procedure, as well as how sensitive the metal detectors are.


Winter is Fall Season For Many Clevelanders
February 2015

With the past winter storm this weekend and the numerous we experience this time of year, serious injuries from ice-related falls occur inevitably. Falls on icy surfaces are a major cause of ankle sprains and fractures, and it’s critical to seek prompt treatment to prevent further damage that can prolong recovery.

Ice accelerates the fall and often causes more severe trauma because the foot can go in any direction after slipping.

In cases of less severe fractures and sprains, it’s possible to walk and mistakenly believe the injury doesn’t require medical treatment. Never assume the ability to walk means your ankle isn’t broken or badly sprained. Putting weight on the injured joint can worsen the problem and lead to chronic instability, joint pain and arthritis later in life.

Some people may fracture and sprain an ankle at the same time, and a bad sprain can mask the fracture.

It’s best to have an injured ankle evaluated as soon as possible for proper diagnosis and treatment. If you can’t see a podiatrist or visit the emergency room right away, follow the RICE technique – Rest, Ice, Compression and Elevation – until medical care is available. According to the ACFAS consumer Web site, FootHealthFacts.org, even though symptoms of ankle sprains and fractures are similar, fractures are associated with:

  • Pain at the site of the fracture that can extend from the foot to the knee
  • Significant swelling
  • Blisters over the fracture site
  • Bruising soon after the injury
  • Bone protruding through the skin—a compound fracture, which requires immediate attention!

Most ankle fractures and some sprains are treated by immobilizing the joint in a cast or splint to foster union and healing. However, surgery may be needed to repair fractures with significant mal-alignment to unite bone fragments and realign them properly, therefore medical attention is required immediately.

If you have injured your ankle in any way please give our office a call to schedule an appointment, 440-442-3113.


Pro Athletes Not the Only Ones at Risk for Achilles Tendon Injuries
January 2015

You don’t have to be an accomplished athlete like the ‘Wild Thing” Anderson Varejao from the Cleveland Cavaliers to suffer Achilles tendon injuries. They can happen from household tasks like climbing a ladder.

Achilles tendon weakness is common in adults, but seeking treatment when symptoms occur can prevent more serious injury.

Achilles tendonitis is common for anyone whose work routinely puts constant stress on their feet and ankles. Achilles tendon injuries happen most often to less conditioned, ‘weekend warrior’ athletes who overdo it. But it can also happen to those who may simply climb a ladder too quickly.

The Achilles tendon is the longest and strongest tendon in the body. It is subjected to considerable wear and tear. When the tendon becomes inflamed from overuse, or sudden stress, tendonitis can weaken it over time and cause microscopic tears.

Individuals risk further deterioration and possible rupture when they don't seek medical care for Achilles tendon injuries. The main symptoms of Achilles tendonitis is pain, which occurs in the morning, improves with motion, but gets worse with increasing stress and activity, stiffness and tenderness.

Treatments for this condition can include:

  • Casting to immobilize the Achilles tendon and promote healing
  • Ice to reduce swelling
  • Non-steroidal anti-inflammatory medication to reduce pain and inflammation
  • Physical therapy to strengthen the tendon
  • Surgery, if other approaches fail to restore the tendon to its normal condition

Major causes of Achilles tendon injuries involve jumping and running. In sports like basketball and tennis, muscles and tendons in the back of the leg are prone to injury from an imbalance that occurs from a lot of forward motion. As a result, the frontal imbalance can weaken the tendon unless stretching exercises are performed regularly.

The best way to prevent Achilles tendon injuries is to warm up gradually by walking and stretching. Avoid strenuous sprinting or hill running if you are not in shape for it.

If you or someone you know has symptoms of Achilles tendonitis, please contact our office for a consultation, 440-442-3113, we are here to help!


Foot Injuries Increase in the Winter Months
January 2015

As temperatures dip across the United States, the prospect of a long winter and slippery conditions is at the forefront of everyone's mind. But as we continue to unpack our winter clothes and re-stock our snow removal essentials, awareness of cold-weather related injuries - and appropriate treatments - is an equally important precaution.

Throughout the winter months, some hospitals report up to a 500 percent increase in emergency room visits, in part due to injuries from slips and falls. Stress fractures, a hairline crack in a bone of the foot, are one of the more common winter-related injuries, and can make seemingly easy activities like walking very painful; if left untreated, these injuries can lead to a complete break in the bone.

Stress fractures are often ignored by people who do not make the connection between a recent activity or accident and related foot pain. According to the American College of Foot and Ankle Surgeons, stress fractures can occur in a wide variety of seemingly benign circumstances. Athletes are commonly afflicted, as repetitive weight bearing activities such as running, gymnastics, and other sports are often sources of stress on the foot. But in the winter months, slippery walking conditions and seasonal sports like ice skating, snowboarding and sledding are some of the leading causes of foot-related injuries.

Even standing on a hard floor for too long can produce a stress fracture. Our practice has treated several patients with stress fractures in December after they volunteered at a local food drive or soup kitchen over the holiday season.

It's important to be aware of the signs of a stress fracture, especially following a potentially stressful activity or fall, and to seek appropriate care. Pain, swelling, redness, and possibly bruising can all be signs of a stress fracture. The pain typically occurs on the top of the foot. The symptoms usually pop up quickly and then subside if the person stops the activity.

Although the foot may feel better with rest, pain often comes back once activity is resumed. At this point in time, people with stress fractures may experience a deep, aching pain that's extremely bothersome. For those who still have symptoms after resting, icing, and using anti-inflammatory medication at home, it's important to see a specialist. Podiatrists can quickly diagnose stress fractures through a physical examination and, if medically indicated, taking imaging studies.

Beginning treatment as soon as possible is very important and may shorten your recovery time. Treatment can take four to six weeks if you catch the problem early. During this time, it's important to rest the foot and possibly wear a surgical shoe or cast boot. In a small percentage of patients, surgery may be needed to stabilize the fracture.

It's not unusual for stress fractures to recur in some people. This is especially true among those who have a certain foot shape or fragile bones. Whether it's a first-time occurrence or a recurrence, proper treatment of a stress fracture is important, and that includes giving your foot the full rest that it needs.

If you or someone you know is suffering from a stress fracture please give our office a call, 440-442-3113.


Frostbite
January 2015

With the extreme cold front hitting Cleveland currently, here is some important information regarding frostbite, a condition that can occur with these dangerously cold temperatures. Frostbite occurs when a body part is exposed to extreme cold. If conditions are cold enough for the water within the tissues to freeze and form ice crystals, cell death can occur. The feet, hands, ears and nose are particularly prone to frostbite due to their location away from the body’s core.

Mild exposure to cold typically produces pain and irritation of the skin. Greater exposure may produce burning and numbness as well as blistering and reversible damage to the outer skin layers. Eventually there will be complete loss of sensation and permanent damage to all layers of the skin, arteries, muscles and tendons.

Signs and symptoms of frostbite include:

  • At first, cold skin and a prickling feeling
  • Numbness
  • Red, white, bluish-white or grayish-yellow skin
  • Hard or waxy-looking skin
  • Clumsiness due to joint and muscle stiffness
  • Blistering after rewarming, in severe cases

Frostbite can be prevented by limiting exposure and keeping the feet as warm and dry as possible. If, however, frostbite is suspected, the feet should be rapidly re-warmed by immersion in warm water (approximately 100 degrees Farenheit). Avoid vigorous rubbing/massaging and dry heat (such as from a hair dryer), as burns may result if numbness is present. To avoid infection, blisters or damaged skin should be treated by medical personnel, therefore, contact our office for an appointment, 440-442-3113, immediately.


Common Runners’ Injury: Stress Fractures of the Foot
March 2015

Stress fractures of the foot are becoming more common in runners, especially first-time marathoners.

The growing popularity of marathons among beginning runners has contributed to the increase in repetitive stress injuries, including stress fractures of the foot. Often, first-time marathoners enter a race with little or improper long-distance training. The lack of experience coupled with the repetitive impact placed on the feet during the run can produce enough stress to cause hairline breaks in the bones of the foot.

Runners who increase their mileage too quickly or change to a more intense phase of training may be more susceptible to a stress fracture due to the increased force placed on the bones. A general rule of thumb for runners is to increase the mileage by no more than 10 percent each week. Runners who are training also need to have adequate rest time in between runs to help decrease the risk of a fracture.

Runners at all levels of experience are also at higher risk for stress fractures if they wear improper shoes while running or training, suffer from flat foot or other foot deformities, or have osteoporosis. Signs of a stress fracture can include pain, swelling, redness and possibly bruising of the area.

Stress fractures can occur anywhere in the foot and can eventually lead to a complete break of the bone if left untreated. Early diagnosis and treatment are important to ensure proper healing.

If a break is suspected, runners must immediately follow the RICE protocol—Rest, Ice, Compression and Elevation. If pain and swelling last longer than a few days, an appointment for an x-ray and diagnosis is in order.

In most cases, treatment includes rest and immobilization with casting of the foot. Surgery may be required in certain instances to repair and stabilize a stress fracture that has progressed into a full fracture.

Runners can take action to prevent repetitive stress injuries in their feet by wearing supportive athletic shoes and slowly building up their activity levels according to their abilities. If a runner suffers from abnormal mechanics in the foot, such as over pronation or hypermobility, custom orthotics can also be helpful to prevent these injuries.

If you suspect you have a foot injury or fracture, please call our office, for evaluation and treatment, 440-442-3113.


Five Signs Your Child May Have a Foot Problem
March 2015

Foot and ankle problems in children often go unnoticed. Signs and symptoms can be subtle, and sometimes children can’t explain what’s wrong. But it’s important to protect growing feet and have problems checked out early.

Below are five warning signs every parent should watch for:

  1. Your Kids Can’t Keep Up with Their Peers
    If children lag behind in sports or backyard play, it may be because their feet or legs are tired. Fatigue is common when children have flat feet. The muscles in the feet and legs tire easily because the feet are not functioning as well as they should.

  2. Children Voluntarily Withdraw from Activities they Usually Enjoy
    If they are reluctant to participate, it may be due to heel pain — a problem often seen in children between the ages of 8 and 14. Repetitive stress from sports may cause muscle strain and inflammation of the growth plate, a weak area at the back of a child’s heel.

  3. They Don’t Want to Show You Their Feet
    Children may feel pain or notice a change in the appearance of their feet or nails but don’t tell their parents because they fear a trip to the doctor’s office. Therefore, parents should make it a habit to inspect their child’s feet starting at a young age. Look for any changes such as calluses, growths, skin discoloration, or redness and swelling around the toenails.

  4. Your Child Often Trips and Falls
    Repeated clumsiness may be a sign of in-toeing, balance problems or neuromuscular conditions.

  5. The Child Complains of Pain
    It is never normal for a child to have foot pain. Injuries may seem minor, but if pain or swelling last more than a few days, have your child’s foot examined.

If you’ve noticed any of these signs in your children, please call our office for an assessment.



Frequently Asked Questions Regarding Bunions
March 2015

Here are some frequently asked questions and answers about bunions and their treatment provided by the American College of Foot and Ankle Surgeons.

  1. Are bunions hereditary?
    Bunions are most often caused by an inherited faulty mechanic structure of the foot. It is not the bunion itself that is inherited, but certain foot types that make a person prone to developing a bunion.

  2. Do over-the-counter pads and splints really work?
    Pads placed over the area of the bunion may help minimize pain from a bunion. However, padding and splinting cannot reverse a bunion deformity.

  3. Will my bunion get worse?
    Because bunions are progressive, they don't go away, and will usually get worse over time. But not all cases are alike. Some bunions progress more rapidly than others.

  4. Is it better to have it fixed now, or should I wait?
    When the pain of a bunion interferes with daily activities, it's time to discuss surgical options with your foot and ankle surgeon. Together you can decide if surgery is best for you.

  5. How can I avoid surgery?
    Sometimes observation of the bunion is all that's needed. A periodic office evaluation and x-ray examination can determine if your bunion deformity is advancing, thereby reducing your chance of irreversible damage to the joint. In many other cases, however, some type of treatment is needed, such as changes in shoes, padding, activity modifications, pain medications, icing, injection therapy, and/or orthotic devices. When the pain of a bunion interferes with daily activities, it's time to discuss surgical options with your foot and ankle surgeon. Together you can decide if surgery is best for you.

  6. Will my insurance company pay for the surgery?
    In most cases, yes, however contact your insurance to verify coverage.

  7. Is the surgery painful?
    The amount of pain experienced after bunion surgery is different from one person to the next. Most patients will experience discomfort for three to five days. If you closely follow your foot and ankle surgeon's instructions, you can help minimize pain and swelling after your bunion surgery.

  8. What type of anesthesia is involved?
    Most bunion surgeries involve local anesthesia with intravenous sedation. That means your foot will be numb and you will be given medications to relax you during the procedure.

  9. If I need surgery, how long will recovery take?
    The length of the recovery period will vary, depending on the procedure or procedures performed. Your foot and ankle surgeon will provide you with detailed information about your recovery.

  10. Will I be able to walk normally, or even exercise and run, after healing from bunion surgery?
    In most cases, yes.

  11. How soon can I walk after surgery?
    It depends on your bunion and the surgical procedure selected for you.

  12. How soon can I go back to work after surgery?
    The length of the recovery period will vary, depending on the procedure or procedures performed.

  13. How soon can I drive after surgery?
    The length of the recovery period will vary, depending on the procedure or procedures performed.

  14. Can the bunion come back?
    Yes, there is a risk for bunion recurrence in some cases. Patients can help prevent this by following their doctor's instructions to wear arch supports or orthotics in their shoe.

  15. If screws or plates are implanted in my foot to correct my bunion, will they set off metal detectors?
    Not usually. It can depend on the device chosen for your procedure, as well as how sensitive the metal detectors are.


Winter is Fall Season For Many Clevelanders
February 2015

With the past winter storm this weekend and the numerous we experience this time of year, serious injuries from ice-related falls occur inevitably. Falls on icy surfaces are a major cause of ankle sprains and fractures, and it’s critical to seek prompt treatment to prevent further damage that can prolong recovery.

Ice accelerates the fall and often causes more severe trauma because the foot can go in any direction after slipping.

In cases of less severe fractures and sprains, it’s possible to walk and mistakenly believe the injury doesn’t require medical treatment. Never assume the ability to walk means your ankle isn’t broken or badly sprained. Putting weight on the injured joint can worsen the problem and lead to chronic instability, joint pain and arthritis later in life.

Some people may fracture and sprain an ankle at the same time, and a bad sprain can mask the fracture.

It’s best to have an injured ankle evaluated as soon as possible for proper diagnosis and treatment. If you can’t see a podiatrist or visit the emergency room right away, follow the RICE technique – Rest, Ice, Compression and Elevation – until medical care is available. According to the ACFAS consumer Web site, FootHealthFacts.org, even though symptoms of ankle sprains and fractures are similar, fractures are associated with:

  • Pain at the site of the fracture that can extend from the foot to the knee
  • Significant swelling
  • Blisters over the fracture site
  • Bruising soon after the injury
  • Bone protruding through the skin—a compound fracture, which requires immediate attention!

Most ankle fractures and some sprains are treated by immobilizing the joint in a cast or splint to foster union and healing. However, surgery may be needed to repair fractures with significant mal-alignment to unite bone fragments and realign them properly, therefore medical attention is required immediately.

If you have injured your ankle in any way please give our office a call to schedule an appointment, 440-442-3113.


Pro Athletes Not the Only Ones at Risk for Achilles Tendon Injuries
January 2015

You don’t have to be an accomplished athlete like the ‘Wild Thing” Anderson Varejao from the Cleveland Cavaliers to suffer Achilles tendon injuries. They can happen from household tasks like climbing a ladder.

Achilles tendon weakness is common in adults, but seeking treatment when symptoms occur can prevent more serious injury.

Achilles tendonitis is common for anyone whose work routinely puts constant stress on their feet and ankles. Achilles tendon injuries happen most often to less conditioned, ‘weekend warrior’ athletes who overdo it. But it can also happen to those who may simply climb a ladder too quickly.

The Achilles tendon is the longest and strongest tendon in the body. It is subjected to considerable wear and tear. When the tendon becomes inflamed from overuse, or sudden stress, tendonitis can weaken it over time and cause microscopic tears.

Individuals risk further deterioration and possible rupture when they don't seek medical care for Achilles tendon injuries. The main symptoms of Achilles tendonitis is pain, which occurs in the morning, improves with motion, but gets worse with increasing stress and activity, stiffness and tenderness.

Treatments for this condition can include:

  • Casting to immobilize the Achilles tendon and promote healing
  • Ice to reduce swelling
  • Non-steroidal anti-inflammatory medication to reduce pain and inflammation
  • Physical therapy to strengthen the tendon
  • Surgery, if other approaches fail to restore the tendon to its normal condition

Major causes of Achilles tendon injuries involve jumping and running. In sports like basketball and tennis, muscles and tendons in the back of the leg are prone to injury from an imbalance that occurs from a lot of forward motion. As a result, the frontal imbalance can weaken the tendon unless stretching exercises are performed regularly.

The best way to prevent Achilles tendon injuries is to warm up gradually by walking and stretching. Avoid strenuous sprinting or hill running if you are not in shape for it.

If you or someone you know has symptoms of Achilles tendonitis, please contact our office for a consultation, 440-442-3113, we are here to help!


Foot Injuries Increase in the Winter Months
January 2015

As temperatures dip across the United States, the prospect of a long winter and slippery conditions is at the forefront of everyone's mind. But as we continue to unpack our winter clothes and re-stock our snow removal essentials, awareness of cold-weather related injuries - and appropriate treatments - is an equally important precaution.

Throughout the winter months, some hospitals report up to a 500 percent increase in emergency room visits, in part due to injuries from slips and falls. Stress fractures, a hairline crack in a bone of the foot, are one of the more common winter-related injuries, and can make seemingly easy activities like walking very painful; if left untreated, these injuries can lead to a complete break in the bone.

Stress fractures are often ignored by people who do not make the connection between a recent activity or accident and related foot pain. According to the American College of Foot and Ankle Surgeons, stress fractures can occur in a wide variety of seemingly benign circumstances. Athletes are commonly afflicted, as repetitive weight bearing activities such as running, gymnastics, and other sports are often sources of stress on the foot. But in the winter months, slippery walking conditions and seasonal sports like ice skating, snowboarding and sledding are some of the leading causes of foot-related injuries.

Even standing on a hard floor for too long can produce a stress fracture. Our practice has treated several patients with stress fractures in December after they volunteered at a local food drive or soup kitchen over the holiday season.

It's important to be aware of the signs of a stress fracture, especially following a potentially stressful activity or fall, and to seek appropriate care. Pain, swelling, redness, and possibly bruising can all be signs of a stress fracture. The pain typically occurs on the top of the foot. The symptoms usually pop up quickly and then subside if the person stops the activity.

Although the foot may feel better with rest, pain often comes back once activity is resumed. At this point in time, people with stress fractures may experience a deep, aching pain that's extremely bothersome. For those who still have symptoms after resting, icing, and using anti-inflammatory medication at home, it's important to see a specialist. Podiatrists can quickly diagnose stress fractures through a physical examination and, if medically indicated, taking imaging studies.

Beginning treatment as soon as possible is very important and may shorten your recovery time. Treatment can take four to six weeks if you catch the problem early. During this time, it's important to rest the foot and possibly wear a surgical shoe or cast boot. In a small percentage of patients, surgery may be needed to stabilize the fracture.

It's not unusual for stress fractures to recur in some people. This is especially true among those who have a certain foot shape or fragile bones. Whether it's a first-time occurrence or a recurrence, proper treatment of a stress fracture is important, and that includes giving your foot the full rest that it needs.

If you or someone you know is suffering from a stress fracture please give our office a call, 440-442-3113.


Frostbite
January 2015

With the extreme cold front hitting Cleveland currently, here is some important information regarding frostbite, a condition that can occur with these dangerously cold temperatures. Frostbite occurs when a body part is exposed to extreme cold. If conditions are cold enough for the water within the tissues to freeze and form ice crystals, cell death can occur. The feet, hands, ears and nose are particularly prone to frostbite due to their location away from the body’s core.

Mild exposure to cold typically produces pain and irritation of the skin. Greater exposure may produce burning and numbness as well as blistering and reversible damage to the outer skin layers. Eventually there will be complete loss of sensation and permanent damage to all layers of the skin, arteries, muscles and tendons.

Signs and symptoms of frostbite include:

  • At first, cold skin and a prickling feeling
  • Numbness
  • Red, white, bluish-white or grayish-yellow skin
  • Hard or waxy-looking skin
  • Clumsiness due to joint and muscle stiffness
  • Blistering after rewarming, in severe cases

Frostbite can be prevented by limiting exposure and keeping the feet as warm and dry as possible. If, however, frostbite is suspected, the feet should be rapidly re-warmed by immersion in warm water (approximately 100 degrees Farenheit). Avoid vigorous rubbing/massaging and dry heat (such as from a hair dryer), as burns may result if numbness is present. To avoid infection, blisters or damaged skin should be treated by medical personnel, therefore, contact our office for an appointment, 440-442-3113, immediately.





Dr. Robert D. Weaver, DPM
Dr. Jennifer Zienkowski-Zubel, DPM

510 Fifth Avenue
Chardon, OH 44024
Tel: 440.286.4945
Fax: 440.279.1516
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6551 Wilson Mills Road
Suite 104
Mayfield Village, OH 44143
Tel: 440.442.3113
Fax: 440.442.5137
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26151 Euclid Avenue
Suite 105
Euclid, Ohio 44132
Tel: 440.442.3113
Fax: 440.442.5137
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