Answers to Common Foot and Ankle Injury Questions

When you are diabetic, there are many threats to the health and wellbeing of your feet. Since neuropathy (nerve damage) often accompanies diabetes, you may not be able to feel issues that have developed and now threaten your health. This means you need to use a daily foot inspection to identify problems at the earliest opportunity so you can stay safe. 

When performing a daily foot inspection, you basically need to look for anything out of the ordinary. As a general rule, any discoloration, growth, or wound needs to be reported.  

Specific items you need to check for every day include:

• Scratches, cuts, and abrasions
• Dry, cracked skin  
• Blisters  
• Calluses and corns  
• Plantar warts  
• Ingrown and discolored toenails 

If you find any of these conditions, schedule the earliest possible appointment with our office. 440-331-9383. In the event you can not get in touch with us and you see signs of infection (pain, swelling, warmth, or redness) seek emergency medical services.  

When you have diabetes, you need to give special care and attention to your feet. The disease puts you at risk for severe medical complications – including Charcot foot and diabetic foot ulcers. 

The first step in protecting your feet when you have diabetes is to manage your blood glucose (sugar) levels. Excessive sugar in the body causes widespread, systemic damage. Specific systems impacting foot health for diabetic individuals include the circulatory, nervous, and immune systems. These respective systems all have vital roles throughout the body, including down in the feet. 

In addition to managing sugar levels, specific actions for foot health include protecting your feet, inspecting them for damage, and seeking early treatment when problems are found. 

With that in mind, the best action you can take—in addition to managing your blood sugar levels—is to come see Dr. Ripepi and create a diabetic foot care plan. Following your foot care plan will be essential for making sure your feet are safe and healthy, and problems are caught and resolved at the earliest opportunity. 

An important part of your diabetic foot care plan will be a daily foot inspection. 

Parents, and especially first-timers, can be concerned when they observe flat feet. Depending on the situation, this might not be the worry it would appear. 

To start, pediatric foot arches are often covered with padding until a child is around three-years-old. This means you shouldn’t expect them to be observable as your son or daughter advances from “first steps” to “cruising around home at reckless speeds” seemingly overnight.  

After that time, foot arches still undergo development until around eight-years-old. Until then, many children have what is known as “flexible flatfoot.” This is not a painful condition and the arches aren’t visible when your child is standing or walking. When your child doesn’t have bodyweight on his or her feet—such as when legs are dangling while he or she sits on a tall chair—the arches can be seen. 

Children often outgrow flexible flatfoot over time. In cases wherein they don’t, there usually isn’t pain. 

More concerning would be a case of rigid flatfoot. This is fairly rare and caused by complications with the tarsal bones in the feet. In about half of these cases, both feet are affected. Rigid flatfoot is usually associated with osseous (bone) and/or inflammatory disorders. 

This will depend on an array of factors. A good starting point, however, is by determining if your child’s foot or ankle is hurting. If so, it’s a good idea to schedule an appointment with our office.  

Your pediatrician is needed to monitor your child’s overall health, but when child foot problems arise, you should bring your child to see a specialist who has focused on feet throughout his or her medical training, residency, and years in practice. 

Specific conditions and injuries that are more common include ingrown toenails, sports injuries, Sever’s disease, plantar warts, and pediatric flatfoot. 

Untreated foot problems in childhood can lead to chronic problems later in life. Arthritis can set in where a bone was fractured. A bad sprain could lead to weak ankles and recurrent injuries. Flat feet can become rigid and painful and keep your child from enjoying performing daily activities, much less running or sports. Even an ingrown nail can become infected and need to be removed if left untreated. 

Given the fact conditions are often most effectively treated in early stages, it is better to err on the side of caution and have your son or daughter see Dr. Ripepi. 

Running places a lot of physical force on feet and ankles, but your lower limbs are equipped to handle this naturally. Part of the way they are able to handle the force is through a biomechanical process known as pronation. If your feet pronate correctly—more on that in a moment—running is generally not going to be bad for your feet. 

Pronation is a normal biomechanical process a foot goes through during the ground portion of a step. In this process, the foot actually rotates inward approximately fifteen percent (in a “normal” pronation pattern). If your foot either rotates excessively or insufficiently, areas of the foot end up handing extra force loads they aren’t intended to handle. 

Over pronation or supination (basically, not enough pronation) are both less-than-ideal, but there are ways to help with them. The running shoes you choose are important – as some pairs help control motion (for overpronators), whereas other provide extra comfort (for those who supinate). 

Beyond footwear, we can help by prescribing orthotic devices (if you would benefit from them). These shoe inserts can do a more customized job of regulating motion and providing cushioning. 

Regular exercise is essential for optimal foot health. Running can be a great choice, particularly if you are smart about it. The best course of action is to cross-train, which means incorporating both running and low-impact exercises (cycling, swimming, yoga, etc.) into your workout program. Not sure what is best for you and your lower limbs? Come see us – we can help! 

There are various reasons toenails become yellow, but the most likely explanation is a case of nail fungus (onychomycosis). Fungal infections in the toenails are, unfortunately, fairly common. The responsible fungi are microscopic—so you cannot see them and know to avoid the tiny spores—and typically reside in warm, damp areas, including places where people normally walk barefoot (such as indoor pool decks, gym locker room floors, and communal showering areas). 

Toenail fungus is a stubborn infection, one that usually requires professional treatment. For optimal results, it is best to come in and see us at the earliest opportunity (when the infection is most easily treated). Left unaddressed, this problem will only continue to worsen. 

Beyond a fungal infection, other potential causes of yellow toenails include diabetes, tuberculosis, bronchiectasis, jaundice, psoriasis, and thyroid problems. In some cases, toenails become yellowed simply due to natural aging processes. There is also an extremely rare genetic disorder known as “yellow nail syndrome,” which can present in conjunction with lymphedema. 

Ankle sprains take roughly 6 weeks to heal completely, but severe cases may take up to 4 months. The actual length for your recovery will depend on a variety of factors, including the severity of the injury, adherence to the treatment plan, and the initial measures taken following the sprain.   

To that last point, proper first aid following an ankle sprain is essential for faster healing. After the injury has been sustained, measures to control inflammation—including icing, elevation, and nonsteroidal anti-inflammatory medication—are especially important. Also, the use of the MLS laser on ankle sprains often helps quicken the healing process.  

No matter the length of recovery time, it is important for the injury to be completely healed before resuming physical activity. Going back to high-impact activities before complete healing can potentially cause chronic ankle instability. This instability includes a greater risk of reinjuring the affected ankle. 

Ankle sprains and fractures actually have similar symptoms, so you may want to visit us for an accurate diagnosis of your injury. Also, we can help you know when it is safe to resume your normal activities. 

As with any part of the body, feet can itch for a variety of different reasons. The most common explanation is a case of athlete’s foot. This is a fungal infection that can start between toes and then spread across the foot. There is usually a noticeable redness and the itching or burning sensation is usually strongest after taking off shoes and socks. 

Whereas an itchy foot is often athlete’s foot, there are other possible explanations. Eczema, psoriasis, and skin allergies. With regard to potential allergens, sometimes the dyes used in socks and shoes—or even the detergent used to wash them—can be responsible for an allergic reaction. 

For an accurate diagnosis and effective treatment plan, come see us at either our Parma or Rocky River offices.

Heel pain is a common ailment for patients of all ages. In part, this can be attributed to the fact there are many potential causes of heel pain. To determine why your heel hurts, a good starting point is to identify where the pain is coming from relative to the heel and when it is strongest. 

• If the pain is prominent on the bottom of the heel and tends to be more severe in the morning (especially with the first steps of the day), the likely cause is plantar fasciitis. 
• If the pain is prominent in the back of the heel and tends to worsen during and following physical activity, the likely cause is Achilles tendinitis. 
• If the pain is prominent in the back of the heel and happening to an adolescent child or teen, the likely cause is Sever’s disease. 

There are other causes of heel pain, but these ones are generally the most common – plantar fasciitis is the leading source of heel pain for adults and Sever’s is the leading source for adolescents. 

Whereas heel pain is common, it isn’t “normal.” Pain is your body’s way of letting you know something is wrong and needs to be addressed. If you are suffering from heel pain, contact our office and let Dr. Ripepi treat it for you. 

There are many different causes of heel pain and, accordingly, a variety of treatment options. The good news is conservative (nonsurgical) care is often quite effective in relieving heel pain. This can include options like medication, icing, stretching programs, changing footwear, and orthotic devices. 

In the rare cases where surgery is recommended, it is typically performed to release a tight connective tissue, remove a bone spur, or repair a fractured heel bone. 

We treat every patient on a case-by-case basis, so your treatment plan will be customized to factor in your unique circumstances (the source of the heel pain, your lifestyle and goals, etc.). That said, it is always our hope to be able to provide relief and ultimate recovery without needing to use surgical intervention. Fortunately, we often can.