AF&A Blog

With Nebraska’s impending move to the Big 10, this would be last time the Husker’s could attempt to get a conference win in Texas. The last few weeks of football have been tough here in Austin. The rest of the football world was looking at us as underdogs against the number 5 ranked Nebraska team. It was pretty obvious that Mack Brown and the Longhorn players didn’t pay any mind to all that talk as they prepared for this weekend’s game.

Every member of the UT team put forth the effort to bring home the win. Whether it was Garrett Gilbert picking up yards running, or the defense limiting Nebraska to less than half their average yards, the Longhorns won the game on the ground. Football cleats are especially designed for the traction and durability needed on play on the field, but it is those players feet that must stand up to the running game every Saturday. With over 200 rushing yards collected in this weekend’s win, those players’ feet need some TLC to optimize their play rest of the season. Key things such as applying heat and massaging your feet will increases the circulation and allow their body to bath the muscles in tendons in nutrition and healing growth factors.

After a long day of walking, your feet could also benefit from the same therapy athletes apply. Rest, stretching, and massaging are all things that can help your feet avoid and prevent injury. The Longhorn players benefit from having a team staff to provide the right physical therapy and physician care. You don’t have to be a college athlete to give your feet similar care. Take the time after a long day on your feet to rest and massage them, and be sure to visit AFAS on the first sign of pain or damage.

Until next time, keep those feet happy and healthy Austin! Hook ‘em horns!

We here at AFAS are hoping you had an opportunity to enjoy some live music over the weekend. If not, we’re sure that you’ve had the radio on lately to listen to some music. You may have heard some advertisement about a ‘new’ minimally invasive procedure to correct bunion deformity along with your music. Let’s talk a little bit about bunions and this particular procedure before you decide to get your bunion fixed by that means.

Bunions are a complicated problem. There are many factors that effect if you will get one and how quickly it will progress to pain or discomfort. As foot specialists, podiatrists learn that there are many different angles of motion that are affected. Your podiatrist needs to assess many facets of your deformity before discussing procedures that will correct the deformity and stop it from reoccurring. The ‘tight rope’ procedure attempts to correct one of these angles. There are bones behind each of your toes that are known as metatarsals. One of the angles that must be corrected during bunion surgery is the Inter-Metatarsal (IM) angle, or the angle between the first and second metatarsals. The IM angle between your 1^st and 2^nd metatarsals must be addressed with almost all bunion procedures, but is only one of the components of this multi-faceted problem.

Because this procedure relies on the 2^nd metatarsal to hold the 1^st in better alignment, weak bones or patients with osteoporosis may not be candidates for this type of surgery. The technique was first used to hold the smaller of your leg bones to the larger in order to heal. Unlike that procedure, a quick x-ray of the foot shows the 1^st metatarsal much larger than the 2^nd. The bone holding the deforming tensions is the smaller 2^nd. This fact should make it no surprise that a common complication with this tight rope procedure is fracture of the 2^nd metatarsal. While the tight rope procedure may allow you to walk soon after surgery, a broken 2^nd metatarsal will quickly put you in a non-weight bearing cast and may require another surgical procedure. Both these things will keep you off your feet for some time. Not every patient has this type of complication, but it is a significant one if you’re choosing this procedure because you won’t have to stay off your feet. Please discuss this procedure along with others and consider the risks, alternatives and complications of all. We feel that the better informed you are the better outcome you will have!

Until next time, keep those feet happy and healthy Austin!

A few days from now the world descends upon Zilker Park for 3 days of music. The Austin City Limits Music Festival has become a yearly event in Austin since 2002. This year’s headliners, The Eagles, Muse, MIA, and others, are a testament to the diversity of our great city. Austin City Limits is probably the best known PBS television show. Originally aired from UT Austin in 1976 with Texas music flair, the diversity of the content has made it one of the longest running live music shows on television. While the label “Live Musical Capitol of the World” is self proclaimed, the number and diversity of performers that visit Austin support it.

If you are planning on attending any part of the festival, we here at AFAS hope you take care of yourself while you are there. Here are a few simple reminders we would like to give you to keep you on your feet and enjoying the performances. Firstly, drink plenty of water. While you spend the day out in the warm Texas sun, you need to stay hydrated. Plenty of fluids (not including beer) are the best way to avoid heat stroke, dehydration, or other problems caused by too much sun exposure. Be sure to grab your two 32oz bottles of water before you depart. A second reminder is to use a dose of sun block throughout the day to keep sunburn at bay.

We have talked before about appropriate foot wear for your activity. While the beautiful weather may be beckoning you to wear flip flops or sandals, these would not be your best option. Your feet need something more like a tennis shoe. As you walk about part of the 350 acres that comprise Zilker Park, your feet could really use the support. If you don’t take care of your feet this weekend, be sure to come by AFAS to fix your aches and pains.

^{Until next time, keep those feet happy and healthy Austin!}

The President mentioned the costs associated with it long before the healthcare bill was passed. For anyone living with diabetes or struggling with ulcerations that won’t heal, it is a scary thought. Amputation is the last resort option to save an individual’s life, but at a cost that can only be understood by someone who has experienced it. According to the National Institutes of Health (NIH) diabetic complications are the main cause for amputations of the leg not due to trauma.

Earlier this summer members of the American Podiatric Medical Association gathered for their yearly seminar to teach, learn, and share knowledge with one another. One of the studies that were presented at that meeting dealt with the issue of amputation. The researchers examined 32,000 patients with diabetes and compared their risk factors to their ultimate outcomes. Their findings were that diabetic patients who visited a podiatrist had a significantly lower number of amputations than those who did not. If you are already a patient at AFAS, you should receive a yearly letter to remind you to schedule your annual diabetic foot exam.

We try to take our weekly blog space to educate you on keeping in good health and preventing problems with your feet. Inspecting your feet for changes and maintaining your blood glucose within the recommended ranges are your daily priority if you have diabetes. Living with diabetes can mean changing habits you may have had your whole life, but anything you can do to live healthier can add years to your life. Regular visits with Dr. Thomajan can detect problems early. By assessing where an ulcer might occur, proper off loading and changes to your shoes can stop the issue before it even happens. Don’t become an NIH statistic and make sure a podiatrist is involved in your healthcare.

Until next time, keep those feet happy and healthy Austin!

Tonight’s game aside, the second week of NFL football is complete and along with it some players season. Only two weeks into the season the injury list for the NFL is quite long. With the hard hits on the run, it is no surprise that most of these injuries occur in the knees, ankle and feet.

There is so much media attention paid to the ‘barefoot running trend’ that it seems necessary we visit this topic once more as the summer comes to an end. Lack of footwear obviously opens your foot up to injury from random objects. The development of shoes like the Nike Free and Vibram Five Fingers may help to keep you out of Dr. Thomajan’s office for removal of glass shards or other objects stuck in your foot. These new types of footwear offer some protection but still lack the support of ‘traditional’ footwear. If you haven’t taken the time to slowly allow your body to adapt to this footwear or have not been devoted to the proper training regime, you may need to schedule an appointment for a completely different reason.

While you may be able to avoid getting objects stuck in your feet, the position of your foot may prove to be more problematic. Each one of us has a different variation in foot structure. Some feet will function fine without the support of footwear. Unfortunately, it is much more likely that your foot structure requires some type of support from shoes. The body will attempt to compensate for any lack of support but often the results can be painful or with changes in the way you walk or run. A visit with Dr. Thomajan can help you decide if barefoot running is for you. Part a visit to AFAS may include GAITSCAN computerized assessment in addition to physical examination of your feet.

Our goal here at Austin Foot and Ankle Specialists is to educate you about keeping your feet healthy. There are two books that Dr. Thomajan has written to help do that. Both deal with special issues concerning foot health. ‘Keep Running!’ is most relevant to our discussion of barefoot running. Request your free copy today and learn the best things you can do to avoid injury while running. Until next time, keep those feet happy and healthy Austin!

You don’t have to go very far these days to run into an advertisement for toning shoes. On a recent visit to the store, I noticed almost a fifth of the shoe section was devoted to these types of shoes! It’s high time we take a closer look at their design and claims so that you can make an informed decision next time you go shopping.

The first question everyone asks is “Do they work?” A fair question for any device you are shelling out your hard earned money for. Well, let’s say they accomplish what they are designed for. These shoes create an unstable surface to walk on and your muscles have to help you maintain balance in addition to walking forward. Over long periods of time these added tasks can increase fatigue and lead to injury. Many of these shoes claim to shape your legs, tighten your abs, and help you become more fit. While these shoes may help to some extent, there is no getting around good old physical activity.

Each brand of shoe accomplishes their toning regime a little differently. A shoe made by Reebok claims to offer the benefit of a balance ball workout in their shoe. This is a prime example of the instability we discussed previously. Other shoes marketed by Sketcher and Fila have pretty strange shape. While it may appear to be a new design, this sole is actually a type of shoe modification used by orthopedists and podiatrists for decades. We have a very technical name for this type of modification, a heel to toe rocker sole. The times when these modifications are required are no laughing matter. Rarely prescribed for health individuals, these shoes are most often used in people who have lost motion at the ankle and middle of the foot. This type of sole is thickest in the middle causing a decrease in the forces of the heel striking the ground and increasing propulsion as the toes leave the ground. Pain, such as it associated with arthritis, is another place to allow the shoe to perform the motion that the ankle and foot should do. Eliminating or limiting the natural motion of the foot and ankle in a healthy individual can emphasize some muscle groups but cause problems in others.

We hope to have given you enough information for you to make an informed choice your next visit to the shoe store. You should always remember to ‘ease’ your way into any new footwear or orthoses. Start with limited wear, increasing slowly as time progresses. Until next time keep those feet healthy and happy Austin!

With ‘deep sadness’, tennis pro Serena Williams has decided to listen to her doctor and not play in the US Open. This is obviously a difficult decision for her as friends have noted this is one of her favorite tournaments to play in.

This is also a big headline as she is the number one ranked player in the world. Her absence also prevents her sister Venus and her from defending their doubles title. Though not a happy decision, we here at AFAS feel she is making the best decision. Returning to any activity before allowing proper time for healing will only increase the risk or re-injuring, cause more extensive damage, or leave one with permanent deficits.

The injury that will prevent Serena from competing occurred in early July. While dining at a restaurant, her foot was injured by a broken glass. This type of injury involves a sharp, foreign body. Any foreign body carries inherent risk of infection and your Podiatric physician will clean the wound clean promptly. Depending on factors such as the type of object and the depth of the wound, you may be prescribed antibiotics. A sharp object, like broken glass, can cut tendons, blood vessels, or nerves. The recoveries for injuries such as these are varied. Tendon injuries typically require 6 weeks to heal, with additional time to be toned back to their original strength. It is important to follow your doctor’s instruction when you are recovering from any type of surgery. If Serena Williams can sit out the US Open, you can surely keep yourself off you feet long enough to heal properly. Until next time, keep those feet happy and healthy Austin!

While not a local story, we’re sure you have heard about the man who had his toe bitten off. No, it is not a story that has been passed around the campfire, but rather a Michigan man’s experience earlier this month. The headline “Dog eats Rockford man’s big toe, saves his life” is pretty odd but not entirely out of place in the Midwest. If you take the time to read the article, you’ll see that an Illinois woman had the same thing happen to her only 2 years ago!

But what does all this have to do with the AFAS blog? Well, it gives us a perfect opportunity to talk about diabetes and the associated complications. The man from Michigan was delaying getting checked for fear he might have diabetes. By delaying the diagnosis, the nerves of his feet became so damaged that a small injury to his toe became infected and spread into the bone. This type of infection, osteomyelitis, can spread quickly becoming life threatening.

Diabetes is complicated disease, but you will stay healthier longer by managing your sugars and regular visits with your healthcare team. Simple injuries to your feet can progress quickly if you don’t maintain vigilance. Wearing protective footwear, even while at home, is a good way to protect your feet. Another important step to take is to have your yearly diabetic foot exam. Don’t wait for your family pet to try and help, rather opt for a quick visit to AFAS. Dr. Thomajan can do a lot to keep you on your feet and avoid complications. Until next time, keep those feet happy and healthy Austin!

You have decided enough is enough. That nail has become so painful; you are going take care of it right now! Grabbing a pair of nail clippers buried in your bathroom drawer you prop your foot on the tub and test the limits of your pain tolerance. That ingrown nail of yours has come back time and time again even with your attempts to trim it back. Unfortunately, you there is a pretty good chance you didn’t use proper technique to avoid infection and you probably don’t have a good understanding of the anatomy you are digging into.

A better idea would be to visit a foot specialist like Dr. Thomajan. Four years of medical education beyond college as well as several years of residency training at a hospital allows podiatrists to diagnose and treat a variety of pathologies of the foot. The particular issue of an ingrown toenail too often is complicated by infected or inflamed before making an appointment at AFAS. Don’t wait for this to happen! Remember that pain is never normal and an easy in office procedure, under toe anesthesia, can be done to eliminate the offending nail. One of the most important parts of this procedure is the cleanliness needed to avoid infection, something that bathroom surgery doesn’t afford. Next time you find that ingrown nail causing you pain, opt for a visit to AFAS and put those old nail clippers away! Until next time, stay happy and healthy Austin!