Hey, grown-ups! Children need regular checkups of their feet too!

On Sesame Street, Burt and Ernie, Big Bird, Elmo, Oscar the Grouch, Cookie Monster and more, help teach children their ABC’s and 123’s.  Dr. Vimal Reddy with the First Coast Foot and Ankle Clinic wants to help parents do the same thing with their kid’s feet.

Many foot problems develop at a young age. When caught early enough, severe problems can be prevented or at least minimized. At Jacksonville, FL based office Dr. Reddy can address the needs of children’s feet—including:

How to identify if there is a problem:

A.  Whoops…Ouch!: If your child complains of pain in the feet, knees, and ankles, or you notice regular tripping and falling, there     could be lower body alignment issues.

B.   New Shoes Too Soon?: If the "wear and tear" in your child’s shoes are uneven or excessive, your child may have an unusual gait or foot position.

C.  Carried Away: A child that insists on being carried more than normal may suffer from pain or difficulty walking.

To diagnose the issue Dr. Reddy will analyze walking patterns, choice of shoes, and muscle function, to determine if there is an inherited foot problem present.

A comprehensive "foot physical exam" should be performed:

1. As soon as a child is able to walk
2. At age 3 when the foot is more developed
3. When starting grade school
4. Before engaging in any kind of sports or physical activities.

If you or someone you know may have questions or concerns about their children’s feet, make an appointment to see Dr. Reddy at the First Coast Foot & Ankle Clinic in Jacksonville, Florida.

By Vimal Reddy D.P.M.

Snow may only very rarely be in the weather forecast during winter in Jacksonville FL, but that doesn't mean it doesn’t get a bit chilly. Runners, who frequently hit the pavement or trails early in the morning, often experience the coldest part of a day. As such, it's recommended that runners have two different types of training regimes- one for warmer days (thankfully plentiful in Florida!) and one for cooler days to help keep you going.

Whether you’re a casual recreational jogger or a competitive athlete considering participation in the upcoming “26.2 With Donna – National Marathon to Finish Breast Cancer” consider the following for your “winter running regime”:

1.     Not too much:Do not plan to make any increases in mileage or speed during colder weather. Pushing oneself harder in the cold could lead to injury (and a visit to the First Coast Foot and Ankle Clinic!) 

2.    Warm up indoors:at least briefly before running and be especially vigilant if conditions are wet or perhaps even icy.

3.    Wear clothing appropriate for running in colder weather: Running shoes in good condition are a must. Try thick, absorbent, dry socks and make sure you have adequate space in your running shoes to accommodate these thicker socks; consider buying a half-size larger running shoe for your winter regime. Also, wear a warm hat. A significant amount of body heat is lost directly from the head, which affects the whole body's circulation.

4.    Be mindful of the wind-chill factor! Some runners prefer to run into the wind to start off and then return with the wind at their backs. The return run is easier since you have perspired and your body is warmer.

5.    Protect your skin!Use a moisturizer, protective lip balm, and sun block to prevent blister formation and redness in the face area.

6.    Stay Hydrated:Drink PLENTY of water before and after running to ensure your muscles recover after running in cold weather.

7.    Most Importantly:Be safe, stay warm, and HAVE FUN!

By Dr. Vimal Reddy

Lucky the Penguin wasn’t so lucky at birth.  He was born with a badly deformed foot, which made it difficult for him to swim and when walking develop sores, which would get infected. The zoo vet determined surgery would be too risky. Luckily for Lucky Teva, a local shoe company stepped forward and was able to engineer footwear to help Lucky function normally.

At the First Coast Foot and Ankle Clinic, Dr. Vimal Reddy sees this issue on a daily basis; but in humans, not penguins, of course. With diabetes a growing problem in Jacksonville FL, severe case can result in foot deformations called Charcot [shar-COH] neuroarthropathy or simply Charcot Foot. Like Lucky the Penguin, people with Charcot Foot have altered bone structure.  Walking will put stress on the foot in ways that can damage it, resulting in sores that can become infected. Like Lucky the Penguin, people with Charcot Foot are able to benefit enormously from custom shoes designed to distribute pressure across the foot.

For some, surgery could be the option to correct a foot deformity like Charcot but it’s no walk in the park. The procedure takes a great deal of metal fixators (plates, screws, pins, etc.) and the recovery period is long. For the right patient, it’s worth it if it can restore a patient’s ability to function normally.   Although surgery isn’t for everyone, patients like Lucky the Penguin will do just fine with their custom shoes.

If you have any questions or concerns for yourself of someone you love, please don’t hesitate to contact the First Coast Foot and Ankle Clinic to set up an appointment today.

By Vimal Reddy

Three of Jacksonville’s most promising young wide receivers at First Coast High School are potentially leading their team to a perfect season. What makes this so remarkable is two out of the three athletes have struggled with injuries this season. It’s always an inspiring story when athletes overcome a setbacks like an injury to put together a winning season. With proper rehabilitation managed by a podiatric physician such as Dr. Vimal Reddy, an injury does not have to mean the end of your days competing on the football field.

One receiver, Brandon Brooks suffered from a broken ankle. The most common injury in sports is the sprained ankle, which occurs when twisting or rolling your foot inwards. If you roll or twist your foot in the opposite direction, it will likely break.

The ankle joint consists of the:

• Talus (the ankle bone)
• Tibia (the shin bone)
• Fibula

The bony bumps you can feel at your ankle are actually the lowest parts of the tibia (inner) and fibula (outer). During ankle fractures, one or both of these bony bumps will break off. Dr. Reddy will first check the bone fragments for stability to see if they will heal on their own.

Ankle fractures almost always need surgery to heal.  Dr. Reddy would make a small cut over the broken bone and drill screws into the bone fragments so they stay connected.  After surgery, you will need to stay off your ankle for 3-4 weeks, followed by a few weeks in a walking cast and physical therapy to help regain your strength to get back on the field.

By Dr. Vimal Reddy

With the Holiday Season officially under way, ski trips are a great way to make the most of your time off during the wintery weather. While a snowy mountain may not be the first thing that comes to mind when you think of Jacksonville, FL, getting away from the grey skies and misty rain to pristine white ski slopes can be a pleasant change of pace. For those of you who make regular trips, or if you just want to try skiing, Dr. Vimal Reddy offers these tips to make the most of your ski vacation.

1.     Keep your feet warm: Being out with ice cold feet can ruin your day. Make sure not to store boots outdoors overnight, making them frigid the next day.  Also, Invest in thermal socks they are worth the expense. By keeping your feet warm, not only will it be more comfortable, you lessen your risk for cold injuries such as chilblains or  frostbite.

2.     Wear properly fitting boots: Dr. Reddy recommends this for running shoes as well, but it is twice as important in skiing.  Due to the trauma that affects your feet on the bottoms, sides, tips of the toes and ankles, boots should be tight enough to cushion your feet, but not too tight as to bruise your toes or cut off circulation.

3.     Stretch out…Just like any other sport: If you limber up before skiing, you can improve your performance and lessen the chances of developing cramps. This article features some easy stretches to do before hitting the slopes.

4.     Know your skills and know your limits: While a ski vacation is enjoyable and unforgettable, don’t attempt a run that is beyond your level. An inexperienced skier might not be able to react to the twisting forces of the ground against the skis.  This could potentially lead to severe ankle sprains or worse. Enjoy the beauty of a crisp winter day while you relax on a run you can manage… don’t try and overdo it.

If you or anyone you know has more questions about winter and their feet, please contact the First Coast Foot and Ankle Clinic to make an appointment

By Dr. Vimal Reddy

Recently new strains of antibiotic-resistant infections have been popping up throughout Europe.  Due to the over-use and abuse of antibiotics, these bacteria have developed defenses against the drugs doctors utilize most to fight infections. Concerns of this “super bug” migrating across the Atlantic Ocean and potentially making its way to The First Coast are a little alarming.

So what does this have to do with podiatry in Jacksonville, FL? On a daily basis Dr. Vimal Reddy prescribes antibiotics to:

Treat infections from diabetic ulcers

Prevent infection after surgery on painful:

• Bunions
• Hammertoes or
• Neuromas

The emergence of this “super bug” would require an entirely different approach to treating and preventing infections in the future. The good news for now is these antibiotic-resistant bacteria are not the usual bugs encountered at the First Coast Foot and Ankle Clinic. If you have any questions or concerns, please request an appointment to speak with Dr. Reddy.

By Dr. Vimal Reddy

The APMA recently described the U.S. Hispanic population as being at the center of a “perfect storm” for diabetes diagnoses. Contributors of type 2 diabetes include:

1. Genetics
2. Poor diet
3. Lack of exercise

Unfortunately Hispanics are at risk for all three, making them 66% more likely than non-Hispanic whites of becoming a diabetic. This news is especially important in Florida, where Hispanics are nearly one quarter of the population.

Regardless of one’s racial makeup, the good news is that knocking your socks off may be the answer!  The APMA campaign encourages those with diabetes to take the first step to avoid some of the most serious difficulties of diabetes: Get an annual foot exam from a podiatrist. By checking in with Dr. Vimal Reddy at least once a year, he will be able to examine your feet and watch for complications.  Some of the complications that can be prevented include:

• Nerve damage (neuropathy)
• Calluses
• Foot Ulcers
• Amputation

If every at risk individual had an annual foot exam, it could save the U.S. an estimated $3.5 billion each year—and it could save your foot.  There’s no better time than NOW to make an appointment with Dr. Reddy at the First Coast Foot & Ankle Clinic in Jacksonville, FL for your yearly diabetic foot evaluation.

By Dr. Vimal Reddy

Do you have dry peeling skin or calluses on your feet?  If a few state there is a new and controversial treatment currently offered by pedicurists—not podiatrists. Just like any regular pedicure, your feet are place in a tank of water, but instead of a pumice stone or razor used on your rough spots, tiny “doctor fish” swim around sucking the dead skin off the bottom of your feet. The fish have no teeth, so the procedure is completely painless, but perhaps ticklish for some.  If you are feeling adventurous, this may be a therapy you are willing to try!

Your skin consists of two layers:

1. Outer epidermis

2. Inner dermis.

The epidermis grows from the inside out and at the outermost levels the skin cells are dead. These dead skill cells act as a barrier to the outside world and eventually will shed away. The fish take advantage of this normal function and eat away at the dead outer layer. This results in skin that is softer, smoother and more cosmetically pleasing.

So, whoohoo, softer feet!... But is it safe? Some state cosmetology boards, including Florida, require tools be sterilized between uses.  Since it’s impossible to sterilize fish, unless you want to add a snack after your pedicure, the fish are banned. For now you will need to leave Jacksonville, FL to receive such a treatment. However, if after receiving a pedicure at any local nail salon in the area, and your feet just don’t seem the same, the First Coast Foot and Ankle Clinic is here to help.

By Dr. Vimal Reddy

Do you wake up in the morning feeling pain in your heels? If so, there is a good possibility you are suffering from plantar fasciitis - inflammation of an important supporting ligament (the plantar fascia)on the bottom of the foot. 90% of people at one point or another in their lives will be affected by this condition.  In many cases, the pain goes away on its own. These exercises will help speed the process up:

1. Stretching: Your foot is an arch supported by several ligaments, including the plantar fascia. By stretching it out, it is loosened and strengthened. A good exercise is to sit on the floor with your legs forward and knees straight. Wrap a towel around the ball of your foot, and pull back for 30 seconds, and then repeat for another 30 seconds. This will not only stretch your plantar fascia, but also your calf muscles and Achilles tendon. This muscle group actually wraps around the heel bone and is continuous with the plantar fascia, so by stretching this muscle, you will relieve plantar fascia pain!
2. “ABC”…Draw the alphabet with your toes: On the bottom of your foot are 4 layers of tiny muscles, which contribute to stabilizing the foot when you walk. By making fine movements with your toes, you will strengthen these muscles that help support the arch, so the plantar fascia won’t need to do so much work.
3. Toe crunches: Just like drawing the alphabet, this also will strengthen the small muscles of the foot that underlie the plantar fascia.

These exercises can be done before going to bed at night or when you wake up in the morning. If all goes well, the exercises should minimize your pain. However, Dr. Vimal Reddy warns that not all heel pain is plantar fasciitis. Furthermore, it can be a symptom of a bigger problem. If your pain does not improve or gets worse after two weeks, request an appointment with Dr. Reddy at the First Coast Foot & Ankle Clinic in Jacksonville, FL to see if a more advanced treatment will help.

By Dr. Vimal Reddy

Bad news for those strutting their stuff around Jacksonville, FL in Reebok EasyTone shoes: Reebok recently agreed to settle a $25 million lawsuit filed by the FTC. The international shoe company claimed their EasyTone shoes strengthen:

• Buttock muscles (gluteals) by 28 percent
• Calves and hamstrings by 11 percent.

Although these are very powerful muscles (the gluteals lift the body up stairs and calves propel the body forward) the FTC alleges this to be false advertisement. For a shoe to boast these kinds of strength gains is amazing—and hard to believe.

Supposedly the shoe works because the unstable sole forces the individual to use other muscles in the lower leg to stabilize the body. At best, Dr. Reddy believes the unstable shoe could help to improve balance and strengthen some of the stabilizing muscles of the lower leg—possibly leading to improvement in athletic performance. On the flip side, feet like a flat surface and will bend side to side until they are leveled out. These unstable soles may actually force the foot into bending in ways that are harmful to the wearer. It may even damage the very muscles you are trying to strengthen!

Despite advanced technology and flashy marketing, it’s still best to wear stable and sturdy walking shoes. If you want to tone your calves and glutes you’ll get better results the old fashioned way—diet and exercise… Sorry.

By Dr. Vimal Reddy

Jaguars fans are getting excited about the upcoming game against the New Orleans Saints this Sunday at Jacksonville’s EverBank field. Unfortunately in a recent game against the Jacksonville Jaguars, New York Jets center Nick Mangold was taken out of the game due to injury. Mangold suffered a high ankle sprain—a tear in the ligaments connecting the two bones of the lower leg, the tibia and fibula.

Ordinary ankle sprains usually occur as a result of tears to the ligaments connecting the leg bones to the bones of the heel and foot.  This typically happens as a result of the foot rolling inwards toward the center of the body. On the other hand, high ankle sprains are the result of the foot twisting outwards, which can cause ankle fractures if the motion is more violent.

As with many traumatic sports injuries, Dr. Vimal Reddy recommends the RICE treatment to keep down the swelling and to reduce pain and inflammation:

• Rest
• Ice
• Compression
• Elevation

To diagnose a high ankle sprain, Dr. Reddy will order an MRI to see if there is separation of the leg bones or fluid leakage from the ankle joint. If the bones are not moving around, the injury is said to be stable and the patient will be back on their feet in days or weeks.  If the tibia and fibula (the two bones of the lower leg) have separated, surgery may be necessary to repair the ligaments and recovery will be much slower. The First Coast Foot and Ankle Clinic looks forward to a victory this weekend for the Jaguars and no injuries on the field.

By Dr. Vimal Reddy

Whether you are a weekend warrior suffering from irritated tendons or the Minnesota Vikings defensive tackle Kevin Williams suffering from plantar fasciitis, the First Coast Foot and Ankle Clinic may have your solution. Extracorporeal Pulse Activation Treatment (EPAT) is a new therapy able to help people with inflamed and irritated tendons. The best part... No surgery required!  Other treatments effective in taking care of such aches and pains are:

• Custom orthotics
• Physical therapy
•  Stretching
• and the dreaded…cortisone injections

EPAT is the most advanced and highly effective, non-invasive, treatment method approved by the FDA. The word extracorporeal means the entire treatment takes place from outside of the body—no knife required. It then transmits shockwaves through the tissue to the area of injury causing micro-trauma. This will stimulate blood flow to the area and insure the injured tendon receives the nutrients it needs to heal. Because EPAT works by causing small, localized areas of inflammation, avoid taking anti-inflammatory medications like aspirin, ibuprofen, and so on. The benefits include:

• Cost effective
• Patients are immediately fully weight bearing
• Bilateral patients can be treated at the same time
• Returning to your work/normal routine within 24-48 hours after the procedure

The procedure itself is performed in our Jacksonville, FL office and takes less then half an hour. While it is not painless, patients usually are not in extreme discomfort. Dr. Reddy will anaesthetize the area to minimize any pain.  The expected results are often experienced after only 3 treatments at weekly intervals but may take up to four weeks for pain relief to begin.  The overall goal is to achieve maximum healing in minimum time.

By Dr. Vimal Reddy

First Coast Foot and Ankle Clinic is excited to announce MLS laser therapy! Dr. Vimal Reddy is one of few in Jacksonville, FL who is currently offering this amazing treatment.  The laser therapy painlessly and effectively relieves:

Many diseases treated by podiatrists involve pain, swelling, and inflammation. The MLS laser will counter the injury on all three fronts completely pain free! It’s like shining a flashlight on one’s skin. Unlike with cortisone injections, the patient can continue to be active throughout their therapy. Most individuals will feel relief within their first few visits, but Dr. Reddy recommends 6-10 treatments depending on the situation.

How does this amazing therapy work?  MLS stands for Multi-wave Lock System. Photons of laser energy penetr

ate deeply into tissue and accelerate cellular reproduction and growth, thus speeding up the recovery process.  As inflammation is reduced, so is the pain.

While MLS laser treatment shows tremendous promise, many insurance plans still consider it an experimental therapy and unfortunately do not cover the therapy.  This may change as studies continue and as patients continue to feel the results.  To find out more about relieving your foot and ankle pain today please contact us at (904) 739-9129.

By Dr. Vimal Reddy

A recent study in the Archives of General Psychiatry found that in the past decade the number of Americans taking antidepressants has doubled.  Psychiatrists are not prescribing most of these antidepressants because the majority of Americans taking antidepressants are not being treated for depression. The drugs are not being used to treat a mental health problem so it’s unnecessary to call in the mental health specialists.

Using antidepressants to treat conditions other than depression might sound wrong, but some drugs have more than one use. The FDA must initially approve a new drug for a specific condition, for example, treating depression.  If a new use for a drug is discovered, doctors are free to prescribe it for that use as long as they find it justifiable. After many studies and trials, the FDA might approve the drug for a new purpose beyond what it was originally invented for.

So how is this relevant to podiatry? According to Dr. Vimal Reddy, a variety of diseases—including diabetes—result in painful tingling sensations in the feet, peripheral neuropathy. It has been discovered that certain drugs used to treat depression also have the benefit of reducing these painful sensations. Under the care of a physician, these drugs are generally safe and can provide relief for those suffering from peripheral neuropathy. With the diabetic population growing, even in Jacksonville FL, more people will suffer from peripheral neuropathy and seek the relief these antidepressants may provide.

By Dr. Vimal Reddy

After nine years with the Houston Rockets Yao Ming announced his retirement. Affecting his decision to retire was a stress fracture in his left foot. While it is not stated which bone he fractured, it is probably his heel bone (calcaneus), or his second metatarsal—one of the bones of the front of the foot where the toes attach.

Stress fractures are a consequence of repeated weight on a bone without enough periods of rest. It is especially common in sports such as basketball, tennis, dance, and gymnastics, because an athlete will need to literally stay on their toes during play and training.

Whether you are the star center of the Houston Rockets, or a weekend warrior in a local league around Jacksonville, FL The First Coast Foot and Ankle Clinic has these recommendations to help prevent stress fractures:

• Avoid doing too much too soon: Instead, build your way up, setting incremental goals, so your body can become accustomed to your level of activity.
• Diet: include foods rich in calcium and vitamin D to strengthen your bones.
• Rest your feet! This will give your bones a chance to recover from the stress you put them through.
• If it hurts, stop! Stress fractures are tiny, but painful. In fact, they are often not detectable on X-ray. The good news is that fractures are small enough to recover quickly, and, with adequate preventative measures, you’ll be back in the game!

By Dr. Vimal Reddy

“Jeopardy” host Alex Trebek recently made headlines after injuring his Achilles tendon.  When his hotel room was broken into, Trebek chased the burglar down his hallway until he heard a loud pop from his heel.  This is the attachment point for the Achilles tendon, a thick, rope-like structure that connects the powerful calf muscles to the heal bone. A ruptured Achilles tendon is one of the most severe injuries that can occur in the leg, and it must be repaired surgically. Fortunately for the game show host, it looks like he will have a speedy recovery.

While this took place on the West Coast, Dr. Vimal Reddy has some lessons for us here in Jacksonville, FL about what we can do to prevent this devastating injury from happening.

• Stay in shape. At age 72, Mr. Trebek probably leads a less active lifestyle.  For those of us who are able however, staying in reasonably good shape is the best way to prevent injuries in general.
• Warm up before exercising.  Of course, if you need to chase a burglar down a hallway, you may not have a chance to warm up. However, if you do some brisk walking to get your calf muscles warmed up, you lessen the chance of injuring your Achilles.
• Strengthen your calf muscles. A good way to do this is to stand up on your toes and then slowly lower yourself down. Lowering oneself down in a slow, controlled manner will really build up strength.
• Wear the proper shoe gear. Dr. Reddy may sound like a broken record saying this, but wearing the right shoes goes a long way to preventing injury!

As a podiatric surgeon and sports medicine specialist at the First Coast Foot & Ankle Clinic, Dr. Reddy is qualified to perform Achilles tendon repair surgery. Consult with Dr. Reddy for a detailed assessment of your foot structure and recommendations for exercising your legs to prevent such injuries.

By Dr. Vimal Reddy

When is the last time you showed off or took a good look at your legs?  Celebrities like Heidi Klum have made a career out of showing off her legs.  Even going as far as having them insured! 

One of the body’s amazing adaptations is the network of vessels carrying blood from the heart to the feet and back again. Arteries transport blood away from the heart to the feet, and our veins are equipped with valves and muscular pumps to move the blood against gravity back to the heart. 

As we age some will find that the veins of the lower leg have a harder time carrying the blood back up, causing blood can to pool in the lower leg. This will result in swelling (edema)and veins that pop out—varicosities.  Unfortunately, there is not much we can do to prevent varicose veins. The most important factor is genetics, so look to your parents to see what may be in store for your legs. Also, women are particularly at risk.

If you have swollen legs, ankles and varicose veins, Dr. Vimal Reddy recommends:

•  Elevating your legs above the level of your chest: This way, your veins can work with gravity instead of against it! So sit back, kick your feet and chill.
• Compression stockings: available at the First Coast Foot & Ankle Clinic, over the counter or as a prescription. These will compress the feet and legs, preventing blood from pooling in them. To get the most out of your compression stockings, make sure you put them on the moment you get out of bed in the morning and wear them all day.  This may mean you will need to start showering at night.
• In severe cases, more advanced treatment may be necessary. Consult with Dr. Reddy to determine the best strategy for dealing with your varicose veins.

By Dr. Vimal Reddy

After watching the USA and Japan duke it out in over time at the FIFA 2011 Women’s World Cup, one may think to themselves, “Do their feet hurt after all that running around?” The calcaneus, or the heel bone, is the largest bone in the foot and the first part of the foot to hit the ground.  This makes the heel bone more vulnerable to injury and something seen often at the First Coast Foot and Ankle Clinic.

Heel pain is an issue many people on the First Cost deal with and it is commonly attributed to plantar fasciitis. Dr. Vimal Reddy believes it is best to X-ray the heel in order to check for a stress fracture, which can occur in any bone of the foot as a result of overuse. As we age and our bones become weaker, we are more at risk for stress fractures, and the calcaneus is one of the most common places for it to happen.  Utilizing a digital X-ray to quickly and efficiently examine and diagnose, Dr. Reddy can even tell you about osteoporosis, since he is able to use X-rays of the calcaneus as a measure of how strong the bones are.

Of course, people will have accidents and have been known to break the calcaneus, like any other bone in the body. This happens most when individuals fall from great heights and land on their feet.  Sadly, they usually break both, and fractured heel bones are a very serious injury due to the difficulty of healing.  The individual may never function the same way again.  As a podiatric surgeon, Dr. Reddy is qualified to surgically correct these injuries to line up the bony fragments and work towards the best possible recovery.

By Dr. Vimal Reddy

As Cindy Crawford, Enrique Iglesias and Julia Roberts so prominently demonstrate, a mole is an area of the skin with an abundance of pigment producing cells—melanocytes. These can occur anywhere on the body, even on your feet! However, it is important not to confuse these type of moles with the most dangerous form of skin cancer, melanoma.  So before you go out under the Jacksonville summer sun, consider this advice from Dr. Vimal Reddy.

Melanoma occurs when the same pigment producing cells found in moles start to grow and multiply without control. Skin cancer usually occurs on body parts exposed most to the sun: backs, shoulders and legs. Another area of concern and important to examine are our feet.  Early detection of melanoma is critical for successful treatment, so when examining moles on your body don’t forget your feet.

 Who is at risk?

• Individuals with fair skin
• Individuals with numerous moles
• People who spend a lot of time in the sun

The Skin Cancer Foundation has created a list of preventionguidelines.  Here are a few extra tips Dr. Reddy suggestsfor your feet:

• When applying sunscreen, be sure to include the tops of your feet and toes
• Inspect your feet for moles that are changing in shape, size, or color
• Don’t forget to check for moles in between your toes!

When it comes to your skin you should consult with your primary care physician or dermatologist for most questions about any of your moles.  But as a podiatrist, Dr. Reddy is well trained to assess changes to the skin occurring on the feet. Looking over the skin for changes is part of every foot examination at the First Coast Foot and Ankle Clinic.  Please feel free to consult with Dr. Reddy for your questions about melanoma and other skin cancers.

By Dr. Vimal Reddy

With things heating up in Jacksonville, FL, from wildfires to the summer heat, many of us will be sliding into our favorite flip-flops and showing off our toes.  The American Podiatric Medical Association has released a set of Do’s and Don’ts for pedicures. Dr. Vimal Reddy has found that the common theme in all of these tips is to watch out for infectious germs, from bacteria or fungi. Here are the highlights Dr. Reddy at the First Coast Foot & Ankle Clinic picked out:

1.     Trim your toenails straight across, not tapered: Nails want to grow straight out. If your toenails are rounded, they can start to grow sideways into your skin, which hurts! This is also an open invitation for a bacterial infection and the pain level will only increase from there.

2.     Use clean tools: If the salon is not properly sterilizing their tools, bring your own. Also, never share emery boards, because they are porous and can trap germs. Finally, don’t use the same tools for a manicure as for a pedicure, because that can transfer germs from your feet to your hands….Yuck!

3.     Not too dry, not too wet: Moisturizing creams will help dry feet.  Just be careful not to keep your feet confined in a damp environment (especially between the toes!) since this creates an ideal breeding ground for fungi.

4.     Thick discolored nails?: You might have a fungus. If this sounds like you, check in with Dr. Reddy to come up with a treatment regimen to eradicate the unwelcome guest living in your toenail!

By Dr. Vimal Reddy

Have you noticed your child’s toes point inward?  Is your son or daughter pigeon toed? Dr. Vimal Reddy will be able to identify one of the three reasons your child’s feet are doing this.

As children’s legs develop from infancy into adolescence, the bones undergo various twists and turns. Inward pointing toes, or intoeing, may be due to one or more of the following:

• Inward twisting of the thigh bone (the femur)
• Inward twisting of the shin bone (the tibia)
• Inward pointing of the front bones of the foot (the metatarsals)

Will my child grow out of this? In the majority of cases, yes. The bones of the feet will likely straighten out before age 2, while the bones of the shin and thigh might take a bit longer—age 6. The thigh is especially tricky since it twists in such a way that intoeing may not become obvious until age 5. Your First Coast pediatrician will be a valuable resource in helping you decide if you need to watch and wait, or if you need to seek the help of a podiatrist.

While intoeing will usually not cause pain or arthritis, it may lead to children stumbling as they catch their toes on their heels. In each of these cases, treatment generally consists of casting with or without bars. The purpose of these treatment schemes is to gradually guide the bones into a more functional position. It’s important not to wait, since, by age 7 or 8, the bones a child has will be the bones he or she takes into adulthood. In severe cases, surgery may be necessary. Dr. Reddy at the First Coast Foot and Ankle Clinic will be able to help you decide what treatment is best, if any is needed at all.

By Dr. Vimal Reddy

With diabetes on the rise, it is important more then ever for diabetics to manage their health by keeping their blood sugar (or blood glucose) under control. To do this, patients need to check their blood glucose regularly. Here at the First Coast Foot and Ankle Clinic, we take the same position as the American Diabetes Association:

1. Check your blood glucose daily
2. Keep a log to monitor how it changes from day to day

By keeping a close watch over your blood glucose, you are doing something of vital importance for your over-all health, including your feet.  Unfortunately, many people in Jacksonville, FL have trouble maintaining the daily regimen recommended due to:

• Checking your glucose can be painful: To minimize the pain, try to draw blood from different sites each day.                                      

• Glucose test strips are not cheap: If you have difficulty paying for test strips, at the very least try to check your blood                                                            glucose three times a week.

People who do not control their blood glucose are at risk for losing sensation in their feet—a disease called peripheral neuropathy. Without the ability to sense pain, touch, or pressure in your feet, you won’t be able to know if you are doing something that is hurting your foot. At this point, foot care becomes extremely important because of the heightened possibility of injuries and infection.

Being diagnosed with diabetes can seem like a life-altering event, but does not mean you cannot continue living a healthy, active, life.          Dr. Reddy can work with your primary care provider to help you manage your diabetes while still getting the most out of your life.

By Dr. Vimal Reddy

According to this article, there are new shoes out to help you make the most of your springtime walks and summertime strolls. Some of them are quite fancy but also expensive. Dr. Vimal Reddy has these tips for figuring out what is best as you explore scenic Jacksonville on foot!

Tip 1: Spend some money: Cheap shoes will wear out quickly.  You want something that will last you throughout the season.

Tip 2: But don’t spend too much money: Beyond a certain price, high-end shoes are more about fashion than about protecting your feet. Also to keep in mind, this is a shoe you will be replacing after 300-600 miles of walking, or 6-10 months. Take a look at the different models offered by each brand and you might decide the fancy shoe is too much for you!

Tip 3: You can walk in running shoes:  If you are more of a runner, your money will be better spent on a pair of running shoes. No need to dedicate a pair of shoes just for your walks. However, if you are training intensely, it might pay off to have a pair of backup shoes for your ordinary activities. In that case, see tip #2.

Tip 4: Choose a shoe that fits:  Yes, you knew this already, but it bears repeating. Dr. Reddy has written previously on this topic here. You should make sure you have extra room for the tips of your toes (about half an inch).  Make sure the point where the sole of the shoe flexes lines up with the ball of your foot.

To help find the best shoe for you stop by the First Coast Foot and Ankle Clinic.  Dr. Reddy can help recommend what to look for in a shoe that will accommodate your unique foot structure. And remember, every foot is different, so there is no such thing as the “best” shoe.

By Dr. Vimal Reddy

With summer on our heals, you might be thinking about adding miles to your runs along A1A or joining a summer sports league here on the First Coast. Whichever activity you choose, you may be worried about Achilles Tendonitis; a condition where the Achilles tendon becomes sore after over use.

***Just so you know: The Achilles tendon is the thick rope-like structure on the back of your lower leg and one of many tendons we have connecting our calf muscles to our feet. ***

Another important tendon is the posterior tibial muscle. Located behind your shin-bone (the tibia), the posterior tibial (PT) muscle is used for flexing your foot inwards at the ankle joint. This is an important muscle for stabilizing your foot when your heel hits the ground and when your foot pushes off.  Like your Achilles, the PT tendon will become sore if it is overused.

According to Dr. Vimal Reddy, PT tendonitis is characterized by pain that gets worse with running. You will feel the pain in your inner leg, next to the heel cord.  You are particularly at risk if you tend to flatten your feet out, or pronate when you run. Doing this stretches and irritates the PT tendon even more.

Tips for prevention and treatment:

• Arch supports—to minimize the amount you pronate your foot
• Protective taping—again, to restrict movement of your ankle
• Aspirin or other nonsteroidal anti-inflammatory medication
• Brace, walking boot or cast—to immobilize the tendon and give it some rest

In extreme cases, surgery may be necessary to give you some relief. If you pronate when you run or if you have pain, consult with Dr. Reddy at the First Coast Foot and Ankle Clinic to find out what is the best treatment option for your case.

By Dr. Vimal Reddy

With summer on our heels in Jacksonville, FL, many will be slipping into a pair of their favorite flip-flops.  Flip-flops are perfect at the pool or beach. However, if you plan on going for a long walk or know you’ll be standing for several hours, you will need a shoe with a thicker sole for more support.

Problems that arise from wearing flip-flops at the wrong time:

• Tendonitis: Irritation of your Achilles tendon, due to poor arch support
• Heel Fissures: Cracking of the skin on the heels due to the additional friction on your heels
• Toe stub injuries and fractures: due to lack of protection.

Of course, flip-flops aren’t all bad. Some instances                   when flip-flops are beneficial:

• If you sweat excessively: Open-toed shoes will ensure your feet stay dry, particularly between the toes. This is important for preventing fungal infection and maintaining skin strength.
• Public Showers: Always wear flip-flops when using a public shower like you would find at pool or gym locker room.
• If the back of your heel is sore, flip-flops can reduce irritation to the area.
• They’re fun and stylish!

If you are planning on wearing flip-flops, make sure you get a pair with a thick, rigid sole. This will strengthen your foot’s ability to absorb shock. Also, while you’re wearing them, make sure you take it easy on your feet to minimize injury. If you have questions on where to find a more rigid, yet stylish sandal, you can inquire at the First Coast Foot and Ankle Clinic.

By Dr. Vimal Reddy

Do you have burning, tingling pain in the ball of your foot? If so, it is possible you have neuroma.  Neuroma is when nerves on the bottom of the foot become overgrown. When you step down on the foot, the bones press on the swollen nerve, causing the waves of burning, tingling, pain.  Neuromas occur commonly in the ball of the foot between the third and fourth toes. This special case is referred to as Morton’s neuroma.

Dr. Reddy at First Coast Foot and Ankle Clinic has many different treatment options available for this problem:

• Fabricate and apply padding to the foot to prevent the bones from squeezing the nerve.
• Orthotics
• Cortisone injections - this will reduce the inflammation.
• Alcohol injections - if the above measures don’t work, this will destroy the bothersome nerve (neurolysis). Not 100% effective, though.
• Surgery - to cut out the nerve manually, in severe cases.
• Cryogenic neuroablation - a relatively new procedure with similar results to surgery but fewer complications and high patient satisfaction. Instead of destroying the nerve with chemicals, it is frozen.

High-heeled shoes aggravate neuromas. The toe box of a high-heeled shoe is usually tight, forcing all your weight down onto the ball of your foot. These two factors contribute to the swelling and irritation.  So ladies the next time you’re running aorund your office or in downtown Jacksonville with your girlfriends for a night out, if you start to feel a burning, tingling pain in your feeet you may want to consider different footwear.

By Dr. Vimal Reddy

A recent study by Thomson Reuters found if diabetic patients visited a podiatrist just once before complications from a diabetic foot ulcer set in, it would result in $3.5 billion in savings for the US health-care system in one year. Podiatrists like Dr. Vimal Reddy are well trained in the diagnosis and treatment of diabetic foot ulcers.  If caught early the disease process does not escalate like it otherwise would if the patient had not seen a podiatrist, equaling fewer health care dollars spent.

People with diabetes often lose feeling in their feet, known as neuropathy. As a result, an individual with diabetes is more at risk of injuring their feet without knowing so. For example: You decide to check out the Jacksonville Riverside Art Market on Saturday.  Unfortunately, you have a rock in your shoe and walk all day without knowing the rock is rubbing the same spot over and over again. By the time you get home to kick off your shoes, you discover the rock and a fresh new wound. Unfortunately, people with diabetes heal wounds more slowly, causing the wound to become infected more easily. Sadly, many patients can lose their feet as a result. Podiatrists are at the forefront in preventing these disasters, and the physical, emotional and financial savings are substantial.

This is an EXTREMELY big deal and here’s why:

• As a nation, we are already in a cost-cutting mode
• Finding ways to trim health care expenditures is important, and podiatrists can help
• Jacksonville lies just outside the Diabetes Belt, and podiatrists like Dr. Reddy have an important role locally.

If you have diabetes, you have everything to gain from forming a good relationship with a podiatrist. So stop over to the First Coast Foot and Ankle Clinic near St. Luke’s Hospital, and learn how you can save both your feet and your money!

By Dr. Vimal Reddy

Last night you may have been entertained by the fancy footwork of wrestlers such as John Cena, Randy Orton, Triple H and The Undertaker while watching WWE Wrestlemania 27.  Or perhaps you were engaged in the Country Music Awards admiring the couture of your favorite country music stars and taking pleasure in Steven Tyler and Carrie Underwood’s performance of “Walk This Way”.  When it comes to walking into a wrestling ring or strutting your stuff on a stage, many problems can arise in the foot as a result of not wearing the right shoes.  Today I would like to dispel a few myths about shoe sizing to help you find the right fit for your foot.

1. You don’t have a shoe size! – You have a foot size. Your foot size is measured in a Brannock device (pictured above).  In a perfect world, your shoe size and foot size would be a perfect match.  Unfortunately, in reality there are differences between brands and the only way to know which shoe fits best is to try them on! 

2. Sizing shoes: Most clerks at shoe stores will measure your heel-to-toe length. While this is important for making your toes comfortable, the more important measure is your heel-to-ball length. You can measure your heel-to-ball length by using the pointer that slides along the side of your foot on the Brannock device.  Your foot size will be the larger of the heel-to-toe and heel-to-toe sizes. Dr. Reddy can give you a proper and accurate measurement at the First Coast Foot and Ankle Clinic.

The heel-to-ball measurement is important because your foot bends the most at the ball of your foot. When trying on a shoe:

• Bend the shoe as if you were pushing the toes upward
• Make sure the shoe bends around the same place as the ball bends
• Lastly, if the shoe bends in a way that your foot does not then it won’t give you the support you need!

3. Size is just a number: Some patients are self-conscious if their feet measure larger then they would like. Just remember the feet you are born with are the only ones you will have.  So if you’re running around your office in Downtown Jacksonville, or taking a stroll by the St. Johns River, be happy, be comfortable, and wear a shoe that fits!

By Dr. Vimal Reddy

In the beginning of March I discussed bunions:  the at times uncomfortable, and sometimes unsightly bumps, on the inner sides of your feet next to your big toe. Today I would like to focus to the other side of the foot and discuss, Tailor’s bunion, or Bunionette.  Tailor’s bunion refers to a similar deformity as a bunion but on the outer side of the foot next to the pinky toe.  Both types of bunions are seen frequently at the First Coast Foot and Ankle Clinic.

The Tailor’s bunion got its name centuries ago when tailors would sit cross-legged on hard floors for hours at a time*. The pressure from the hard floor on the side of their foot caused irritation to the spot next to their little toe.

While there is a genetic component to tailor’s bunion there are other contributing factors, such as:

• The way you walk: This can stretch the ligaments holding your bones together, causing the bone to jut outwards as a result.
• Wearing High Heels: Compounding the issue, high-heeled shoes will place additional pressure on the toes, accelerating this process of ligament stretching. This progression can give rise to a condition known as splay foot, where the bones on either side of the foot protrude outwards.

Since Tailor’s bunion is usually a natural result of aging, Dr. Vimal Reddy does not find this condition worrisome unless it becomes painful. As always, the goal is to make sure you are comfortable and can go through life easily without being bothered by bunions. We can achieve this with:

• Padding may help reduce pain in the affected area
• Measuring your feet to see if your shoe size has changed
• Icing to reduce pain and inflammation

Surgery is another option to straighten out the bunions but only in severe cases.  Therefore in closing; if sitting cross-legged for hours is causing pain in your pinky toe region, or perhaps you’ve noticed pain in your little toe area while taking a stroll around the Jacksonville, FL St. Johns Town center, consult with Dr. Reddy for appropriate treatment options for your tailor’s bunion.

*Fun fact: The sartorius muscle is the longest muscle in the body, found in the front thigh.  Sartorius derives from the Latin word for tailor because it functions to position your legs in a tailor’s cross-legged position!

By Dr. Vimal Reddy

The Centers for Disease Control has released a new outline where diabetes is particularly prevalent in the United States.  They have dubbed it…The Diabetes Belt. “The Belt” spans across the South, from Tennessee to West Virginia, Louisiana to Georgia, including parts of Northern Florida.  Jacksonville lies just outside of the Diabetes Belt.   While diabetes is clearly a severe problem in other parts of the country, Jacksonville has much room for improvement as well.

While the study does not distinguish between Type 1 (juvenile onset) and Type 2 (adult onset) diabetes, 90% of all diabetics are Type 2. Factors affecting this include:

• Genetics
• Diet
• Lack of exercise

Different counties within the Diabetes Belt also have higher incidence of strokes. This association is not surprising, as diabetes is associated with cardiovascular disease. The same disease process which leads to strokes, also leads to diseases of the blood vessels in the foot. Unfortunately the diabetic foot has poor circulation, taking it longer for wounds to heal.  This is where Dr. Vimal Reddy at the First Coast Foot and Ankle Clinic can help. As a podiatrist, Dr. Reddy is better equipped than doctors of other specialty to address problems that arise in the feet. 

By Dr. Vimal Reddy

Saturday, March 12, 2011 was the 34th Annual Gate River Run. Beautiful Downtown Jacksonville, FL. was taken over by the largest 15K in the country. 14,971 runners finished the race and two of them are TEAM members of First Coast Foot & Ankle Clinic. We would like to congratulate our Office Manger, Jennifer Morris and our Surgical Coordinator, Davy Cotes for finishing the race in 1 hour and 37 minutes. Great job Ladies!

By Dr. Vimal Reddy

Ladies, are you having problems fitting into your favorite heels to strut around Downtown? Gentlemen, do your feet feel suffocated in your shoes by the end of the night out in Jax Beach? Do you have bumps on the insides of your feet next to your big toe? If so, you may have... bunions!

Bunions occur when the bones of your foot have changed shape or orientation. Ultimately, the cause is genetic -- either your supportive structures are not strong enough to hold your bones in place, or the way your foot strikes the ground causes the bones to shift and protrude. Bunions are a mild problem, but can lead to pain and blisters. Cosmetically, many people just don't like the way they look and unfortunately can become more pronounced as we age. This is a very common condition seen at the First Coast Foot and Ankle Clinic.

The primary goal for Dr. Vimal Reddy, or any podiatrist, is to improve functionality. If you can walk with little to no pain then we are happy! However, bunions often become painful and the first effort is conservative treatment:

• Padding: simple pads will take pressure off of the bunion and alleviate the pain and blistering.
• Shoe sizing: As we advance in age, our feet change. Have Dr. Reddy measure your shoe size to determine if you need a better fitting shoe.
• Orthotics: If the way your foot hits the ground is the cause of your problems, an orthotic shoe insert will correct the way you walk and work towards taking pressure off of the bunion, thus alleviating the pain.

If these treatments are not enough, we may need to try a more aggressive approach such as surgery. Nevertheless, Dr. Reddy always makes surgery his last resort. In addition to the usual surgical risks, there is no guarantee the end result of bunion surgery is any more cosmetically pleasing than your natural foot and over time your feet may revert back to the way they were. However, a trained and experienced podiatric surgeon will know how to address these risks.

By Dr. Vimal Reddy

The Centers for Disease Control released new figures estimating the number of people with diabetes at nearly 26 million. This is an increase of 2.4 million from 2008. Furthermore, the number of Americans with pre-diabetes is up to 79 million. This is a shockingly high increase of 22 million from 2008. These distressing figures indicate that podiatrists such as, Dr. Vimal Reddy, will become increasingly more important in helping the growing number of people living with diabetes and pre-diabetes.

Those with diabetes gradually lose their ability to control their blood sugar. High blood sugar affects blood vessels. When the blood vessels become diseased, problems arise in the foot including loss of sensation and ulcers. Unfortunately, before blood sugar gets high enough to diagnose an individual with diabetes, high blood sugar can and will affect the body. This is why the increasing number of people with pre-diabetes is an important problem to deal with. Many of our patients at the First Coast Foot Clinic in Jacksonville, FL have these same problems, which Dr. Vimal Reddy can address.

Fortunately, we are becoming better at treating diabetes, and people with this disease are living longer and healthier lives. We are also getting better at diagnosing diabetes. Therefore people with this condition can find out sooner to be able to get the treatment they need. If you are at risk or think you may be at risk for diabetes, your podiatrist can advise you on the steps to take to prevent this disease. If you think you may have diabetes, set up an appointment with Dr. Reddy for a foot screening.

By Dr. Vimal Reddy

With warmer weather around the corner, lots of people are ready to get out of the house, lace up their tennis shoes and get outside. With this said, I would like to take a minute to focus on one of the smallest and many times over looked, body part: the big toe. When we run, we push our foot off the ground stretching the big toe backwards. In sports like football, soccer and track, the toe can be stretched too far, causing irritation. This is known as Turf Toe. You will feel pain on the bottom of your toe joint as you are pushing your foot off the ground when running.

Turf Toe is very similar to Achilles Tendonitis. In each case, you are stretching a body part too far, causing irritation and inflammation. In each case, the treatment consists of:

• RICE - Rest, Ice, Compression, and Elevation
• Aspirin - Dr. Reddy will advise if this is appropriate or not
• Getting to the root cause of the condition - make an appointment at Jacksonville's First Coast Foot & Ankle Clinic

If you are wearing shoes that are too flexible, you can easily over-extend your big toe. While athletic shoes should not be too stiff, they should not be too flimsy either; they need to be just right. So if you're training for the upcoming Gate River Run, hitting the gym to get ready for bathing suit season, our just outside getting rid of those winter blues, you want to be able to enjoy these activities pain free. When you make your appointment remember to bring your training shoes with you so Dr. Reddy can properly evaluate if you are getting the protection you need.

By Dr. Vimal Reddy

Whether you're playing in the Super Bowl, having fun with friends or jogging down A1A in Jacksonville Beach, Achilles tendonitis can easily flare up. The Achilles tendon is the thick cord on the back of your lower leg. It connects the powerful calf muscles to the heel. When it happens, you will notice pain an inch or two above your heel. This is the watershed zone of the tendon, the spot where all the blood vessels come in to supply nutrients. Unfortunately, this is also going to be ground zero for the body's inflammatory response. This is a fancy way of saying your body detects the small problem, overreacts, and the small problem becomes bigger and bigger.

The Achilles tendon was named after the invincible Greek warrior Achilles. The only weak point for this Trojan War hero was his heel. And what a weak point it is! Injuries to the Achilles tendon are among the most serious in the lower extremity to be treated by Dr. Vimal Reddy at the First Coast Foot and Ankle Clinic.

Long-term treatments consist of correcting the root cause of Achilles Tendonitis; either your muscles and tendons are stiff because you are doing too much too soon, or you are overpronating (flattening out your feet). In the case of stiffness, you can correct the problem by adding a regimen of stretching before and after exercise. Overpronation can be corrected with custom orthotic shoe inserts.

In the short run, you should rest your sore Achilles. Aspirin may be appropriate to use depending on your situation. For more information, consult with Dr. Reddy to determine the best treatment for your painful Achilles.

By Dr. Vimal Reddy

If you are possibly at risk for gout, that New Year resolution could have you wondering what foods are best to avoid and best to target. When trying to grab something to eat after a long day of shopping at the Jacksonville Town Center or enjoying Historic San Marco, you want to make sure you picking the right foods for yourself.

Gout is a disease which involves swelling, redness, and pain in the joints, usually in your big toe, foot, ankle or heel. Attacks of gout flare up quickly -- within a day -- but usually last no longer than a week. Gout is most common in middle-aged and older men, although it can also be seen in women after they have gone through menopause. In each case, age and genetics are factors.

Another issue, which can increase ones predisposition to gout, is diet. For this reason Hippocrates, an ancient Greek physician, called gout "the disease of kings". In Hippocrates's day, kings were the only ones wealthy enough to eat the rich foods that cause gout.

In an old episode of King of the Hill, Bobby (a middle-school aged boy) contracts gout after eating the wrong kind of food.

If you are at risk for gout, here are some foods to limit or avoid:

• Shellfish
• Liver
• Alcohol -- especially beer
• Fructose -- sweetener in soda

To help lower your risk of gout target:

• Coffee
• Concentrated cherry

Overall, reducing calories will help reduce ones risk for gout attacks. If you think you may have gout, consult with Dr. Vimal Reddy at First Coast Foot & Ankle Clinic for more treatment and prevention tips.

By Dr. Vimal Reddy

Despite the absence of our Jacksonville Jaguars in the NFL playoffs, we have seen an exciting post-season filled with surprises. There are teams who have been celebrated for decades, creating new chapters in some of the most storied rivalries in NFL history. These dramatic matchups are an inspiration to us amateurs. So when we are inspired and try to play like the pros we admire, or for some strut our stuff in the highest of heels like a super model, we sometimes run the risk of injuring ourselves.

This week we focus on one of the most common injuries seen at the First Coast Foot and Ankle Clinic... the sprained ankle. Ankle sprains are common in most sports: football, basketball, volleyball, soccer, and any other activity involving running and jumping.

A sprain is a tear in the ligaments. These ligaments are cords of tissues holding bone to bone at your joints. While they are strong, a sudden overextension of the joint in the wrong direction can cause it to tear. This makes the ankle the most common site of sprains in sports, particularly in the lateral or outer side of the ankle.

The treatment options for a sprained ankle will depend on how severe it is. Usually spending a few days resting your ankle and following the RICE procedure (Rest, Ice, Compress, Elevate) should suffice. However, in very severe cases, an MRI and surgery may be required. If you have an ankle injury and are not sure what to do, contact Dr. Reddy to determine the best treatment strategy.

By Dr. Vimal Reddy

For a brief shining moment the Jacksonville Jaguars were leading their division, on the way to their first division championship since 1998. It was almost possible, but after an unfortunate loss against the Texans, players out due to injuries and another team's win, all that can be said now is: there's always next year. Nonetheless Dr. Vimal Reddy and the rest of the TEAM at the First Coast Foot and Ankle Clinic will continue to support their Jaguars.

Football is a tough sport, especially on the legs. There are many injuries that can occur in the foot and ankle. These include:

• Ankle sprains
• Achilles tendonitis
• Turf toe

One common treatment regimen for such traumatic injuries, whether from football or other physical activity, is the "RICE" strategy:

• Rest
• Ice
• Compression
• Elevation

When we suffer an injury, our body responds with a process known as inflammation. This results in a major increase in blood flow to the injured area. This causes the familiar warmth, redness, swelling, and pain. While it is necessary for healing, our bodies are designed to "overcompensate". Prolonged inflammation is the reason why injuries hurt the worse the day after.

Using the RICE technique can minimize the effects of inflammation. The rest component is easy to understand, but the other techniques may not seem as obvious. By icing and compressing the area, the body is not as able to get blood flow into the injured area. Elevating the injured area allows gravity to carry blood away from the injury. Proper usage of this technique will mean a less painful recovery. However if the pain continues, the injury may be more severe, requiring the need for a professional such as Dr. Reddy to further evaluate the situation.

By Dr. Vimal Reddy

The past few weeks have Jacksonville, FL in winter's grasp, and the chills have been felt here at Dr. Reddy's First Coast Foot and Ankle Clinic. This is bad news for the feet as they are the first parts to be sacrificed when we are exposed to extreme cold. However, our bodies are marvels in terms of the various survival mechanisms we have in place.

Conditions of cold exposure can be broadly grouped into freezing and non-freezing injuries. Non-freezing injuries include pernio, or chillblains. This condition results from changing circulation in response to cold exposure. You'll notice it on the skin because it will be red, itchy, and have a burning sensation. Your skin may even form ulcers.

Of course, you are probably more familiar with frostbite, a freezing injury. Frostbite occurs when the body part becomes so cold that it actually freezes. This is a serious medical condition, and you will need to seek emergency medical treatment. Do not try to rapidly re-warm the exposed area but instead do so gradually. Dr. Reddy will be able to help you form a long-term treatment plan.

The best way to handle cold exposure is to prevent it. Here are some tips:

• Keep your feet dry! Since water will make you lose heat 25 times faster than air.
• Proper footwear! Make sure your footwear is not too tight to allow for proper circulation.
• Avoid alcohol if you will be in a cold environment. This will cause your blood vessels to expand and give off body heat
• Bundle up! This means wear a proper hat, coat, and gloves. If you keep your head and chest warm, your body will be able to maintain circulation of warm blood to the feet.

For treatment options or any questions you may have consult with Dr. Vimal Reddy.

By Dr. Vimal Reddy

Neuropathy can be moderate pain that includes burning, shooting, and stabbing pains to severe pain that includes sensory loss, reduced thermal sensation, and late complications such as ulcers. At least 60% of patients with diabetes have some degree of neuropathy. Diabetes makes your blood sugar level higher than normal. These high blood sugar levels can damage nerves in the body.

The most important thing you can do for yourself is keep your blood sugar as closely controlled as possible and get regular exercise and keep your weight under control. It is the numbness in your feet that can increase your risk for ulceration and amputation, not the pain itself.

There are options to control your neuropathy and not only diabetic are affected. Call today for a consultation on how to treat the burning, tingling and shooting pain in your feet.

Athletic footwear should be fitted to hold the foot in the position that's most natural to the movement involved. Athletic shoes protect your feet from stresses encountered in a given sport and to give the player more traction. The differences in design and variations in material, weight, lacing characteristics, and other factors among athletic shoes are meant to protect the areas of the feet that encounter the most stress.

Well-fitted athletic shoes need to be comfortable, yet well-constructed and appropriate for a given activity. A good fit will mitigate blisters and other skin irritations.

Sports-specific athletic shoes are a good investment for serious athletes, though perhaps a less critical consideration for non-athletes. Don't wear any sport or other shoes beyond their useful life.

A running shoe is built to take impact, while a tennis shoe is made to give relatively more support, and permit sudden stops and turns. Cross training shoes are fine for a general athletic shoe, such as for physical education classes or health club exercising, such as on stair machines and weight-lifting because they provide more lateral support and less flexibility than running shoes. They also tend to be heavier than running shoes, but most people don't need light, flexible shoes for cross-training. If a child is involved more heavily in any single sport, he or she should wear shoes specifically designed for that sport.

Our practice recommends sturdy, properly fitted athletic shoes of proper width with leather or canvas uppers, soles that are flexible (but only at the ball of the foot), cushioning, arch supports, and room for your toes. Try a well-cushioned sock for reinforcement, preferably one with acrylic fiber content so that some perspiration moisture is "wicked" away.

Athletic shoes need to be replaced after one year, whether or not they are worn, and after a certain amount of repetitive load is placed on them and wears them down. The American Academy of Podiatric Sports Medicine advises replacing running or walking shoes after 300 to 500 miles of wear, and replacing aerobic, basketball, and tennis shoes after 45 to 60 hours of wear. Athletic shoes should also be replaced if they show signs of unevenness when placed on a flat surface, display noticeable creasing, and/or when the heel counter breaks down.

Our office will be collecting gently used shoes to donate to the less fortunate of Jacksonville. Please bring them by at anytime during our office hours.

Black or darkened toenails are essentially bruised nails and can result from a variety injuries or problems. Darkened nails may occur as a result of the toe hitting the end or the top of the shoe toe area. Sometimes, the bruise can lead to a fungal nail infection.

Treatment may include trimming the nail back and applying a topical antifungal medication. If the skin under the nail is ulcerated, a topical antibiotic ointment should be applied.

Diabetic patients should contact our office for evaluation if they experience any change in the color of toenails The pressure causing the bruised nail may lead to a small sore under the toenail, which can lead to infection.

Ingrown toenails, also known as onychocryptosis, is usually caused by trimming toenails too short, particularly on the sides of the big toes. They may also be caused by shoe pressure (from shoes that are too tight or short), injury, fungus infection, heredity, or poor foot structure. Ingrown toenails occur when the corners or sides of the toenail dig into the skin, often causing infection. A common ailment, ingrown toenails can be painful. Ingrown toenails start out hard, swollen, and tender. Left untreated, they may become sore, red, and infected and the skin may start to grow over the ingrown toenail.

In most cases, treating ingrown toenails is simple: soak the foot in warm, soapy water several times each day. Avoid wearing tight shoes or socks. Antibiotics are sometimes prescribed if an infection is present. Note: Please consult your physician before taking any medications. In severe cases, if an acute infection occurs, surgical removal of part of the ingrown toenail may be needed. Known as partial nail plate avulsion, the procedure involves injecting the toe with an anesthetic and cutting out the ingrown part of the toenail.

Ingrown toenails can be prevented by:

• Trimming toenails straight across with no rounded corners.
• Ensuring that shoes and socks are not too tight.
• Keeping feet clean at all times.

  Many people don't realize they have a fungal nail problem and, therefore, don't seek treatment. Yet, fungal toenail infections are a common foot health problem and can persist for years without ever causing pain. The disease, characterized by a change in a toenail's color, is often considered nothing more than a mere blemish. Left untreated, however, it can present serious problems.
  
  Also referred to as onychomycosis, fungal nails are infections underneath the surface of the nail, which may also penetrate the nail. Fungal nail infections are often accompanied by a secondary bacterial and/or yeast infection in or about the nail plate, which ultimately can lead to difficulty and pain when walking or running. Symptoms may include discoloration, brittleness, loosening, thickening, or crumbling of the nail.
  
  A group of fungi, called dermophytes, easily attack the nail and thrive on keratin, the nail's protein substance. In some cases, when these tiny organisms take hold, the nail may become thicker, yellowish-brown, or darker in color, and foul smelling. Debris may collect beneath the nail plate, white marks frequently appear on the nail plate, and the infection is capable of spreading to other toenails, the skin, or even the fingernails.
  
  Nail bed injury may make the nail more susceptible to all types of infection, including fungal infection. Those who suffer chronic diseases, such as diabetes, circulatory problems, or immune-deficiency conditions, are especially prone to fungal nails. Other contributory factors may be a history of Athlete's Foot or excessive perspiration.
  
  You can prevent fungal nail infections by taking these simple precautions:

  • Exercise proper hygiene and regularly inspect your feet and toes.
  • Keep your feet clean and dry.
  • Wear shower shoes in public facilities whenever possible.
  • Clip nails straight across so that the nail does not extend beyond the tip of the toe.
  • Use a quality foot powder (talcum, not cornstarch) in conjunction with shoes that fit well and are made of materials that breathe.
  • Avoid wearing excessively tight hosiery, which promotes moisture. Socks made of synthetic fiber tend to "wick" away moisture faster than cotton or wool socks, especially for those with more active lifestyles.
  • Disinfect home pedicure tools and don't apply polish to nails suspected of infection.

  Depending on the type of infection you have, over-the-counter liquid antifungal agents may not prevent a fungal infection from recurring. A topical or oral medication may need to be prescribed, and the diseased nail matter and debris removed, a process called debridement. Note: Please consult your physician before taking any medications.
  
  In severe cases, surgical treatment may be required to remove the infected nail. Permanent removal of a chronically painful nail, which has not responded to any other treatment, permits the fungal infection to be cured and prevents the return of a deformed nail.

Having heel pain, Achilles tendinitis, or other common foot problems can often slow you down. There are many treatments that are effective in taking care of these aches and pains such as orthotics, physical therapy, stretching, and even cortisone injections. However, when other treatments fail to get you back on your feet there is EPAT (Extracorporeal Pulse Activation Therapy). EPAT is the most advanced and highly effective non-invasive treatment method approved by the FDA. It is performed in our office in as little as 15 minutes and generally 3 treatments are necessary at weekly intervals. The benefits include returning to your work/normal routine within 24-48 hours after the procedure, cost effective, patients are immediately fully weight bearing, and bilateral patients can be treated at the same time. The expected results are often experienced after only 3 treatments but may take up to four weeks for pain relief to begin.

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.

Foot problems are a big risk in diabetics. Diabetics must constantly monitor their feet or face severe consequences, including amputation. With a diabetic foot, a wound as small as a blister from wearing a shoe that's too tight can lead to a lot of damage. Diabetes decreases blood flow, so injuries are slow to heal. When a wound is not healing, is at risk for infection and infections spread quickly in diabetics.

When a diabetic foot becomes numb, it may be at risk for deformity. One way this happens is through ulcers. Small, unattended cuts become open sores, which may then become infected. Another way is the bone condition CharcotFoot. This is one of the most serious foot problems diabetics face. It warps the shape of the foot when bones fracture and disintegrate, and yet, because of numbness there is no pain, and the individual continues to walk on the foot. Our practice can treat diabetic foot ulcers and early phases of Charcot (pronounced "sharko") fractures using a total contact cast and prevent more serious damage or deformity. This treatment allows the ulcer to heal by distributing weight and relieving pressure. For Charcot Foot, the cast controls foot movement and supports its contours

If you have diabetes, you should inspect your feet every day. Look for puncture wounds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, cuts, and nail discoloration. Get someone to help you, or use a mirror.

Here's some basic advice for taking care of diabetic feet:

• Always keep your feet warm.
• Don't get your feet wet in snow or rain.
• Keep feet away from heat (heating pads, hot water pads, electric blankets, radiators, fireplaces). You can burn your feet without knowing it. Water temperature should be less than 92 degrees. Estimate with your elbow or bath thermometer (you can get one in any store that sells infant products).
• Don't smoke or sit cross-legged. Both decrease blood supply to your feet.
• Don't soak your feet.
• Don't use antiseptic solutions (such as iodine or salicylic acid) or over-the-counter treatments for corns or calluses.
• Don't use any tape or sticky products, such as corn plasters, on your feet. They can rip your skin.
• 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 for treatment.
• 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 of shoes everyday. Inspect the inside of each shoe looking for foreign objects, protruding nails, or any rough spots inside before putting them on. Don't lace your shoes too tightly or loosely.
• Choose socks and stockings carefully. Wear clean, dry socks every day and always wear socks with shoes. Avoid socks with holes or wrinkles. Thin cotton socks are more absorbent for summer wear. Square-toes socks will not squeeze your toes. Avoid stockings with elastic tops or garters.
• Never wear sandals or thongs (flip-flops) and never go barefoot, indoors or out.
• In the winter, wear warm socks and protective outer footwear. Avoid getting your feet wet in the snow and rain and avoid letting your toes get cold.
• Don't file down, remove, or shave off corns or calluses yourself.

Contact our office immediately if you experience any injury to your foot. Even a minor injury is an emergency for a patient with diabetes.

Coming soon.

Your feet are the foundations of your body and then they are out of alignment, excess strain is being placed on your joints. Many of the aches, pains and injuries common to exercising can gradually be eliminated with the proper orthotic support.

Those who benefit from orthoics are many including people with plantar fasciitis, flat feet, and high arches. Plantar Fasciitis is the term commonly used to refer to heel and arch pain traced to an inflammation on the bottom of the foot. More specifically, plantar fasciitis is an inflammation of the connective tissue, called plantar fascia, that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts into the heel bone.

Overpronation is the most common cause of plantar fasciitis. As the foot rolls inward excessively when walking, it flattens the foot, lengthens the arch, and puts added tension on the plantar fascia. Over time, this causes inflammation.

Flat feet are a common condition of the foot structure. Painful progressive flatfoot, otherwise known as tibialis posterior tendonitis or adult-acquired flatfoot, refers to inflammation of the tendon of the tibialis posterior. This condition arises when the tendon becomes inflamed, stretched, or torn. Left untreated, it may lead to severe disability and chronic pain. People are predisposed to tibialis posterior tendonitis if they have flat feet or an abnormal attachment of the tendon to the bones in the midfoot.

Orthotics that are custom made support and realign the body to gently lift the arch into its proper position. Custom orthoics are available in our office and even some insurances cover the cost. If you are experiencing any foot pain or the above mentioned problems please call to make an appointment today.

Understanding the basic construction of shoes will help you make more informed decisions and select shoes that fit your foot and needs.

Shoes are made up of five major components:

• The toe box is the tip of the shoe that provides space for the toes. Toe boxes are generally rounded, pointed, or squared and will determine the amount of space provided for the toes.
• The vamp is the upper middle part of the shoe where the laces are commonly placed. Sometimes Velcro is used instead of laces.
• The sole consists of an insole and an outsole. The insole is inside the shoe; the outsole contacts the ground. The softer the sole, the greater the shoe's ability to absorb shock.
• The heel is the bottom part of the rear of the shoe that provides elevation. The higher the heel, the greater the pressure on the front of the foot.
• The last is the part of the shoe that curves in slightly near the arch of the foot to conform to the average foot shape. This curve enables you to tell the right shoe from the left.

The material from which a shoe is made can affect fit and comfort. Softer materials decrease the amount of pressure the shoe places on the foot. Stiff materials can cause blisters. A counter may be used to stiffen the material around the heel and give added support to the foot.

The NEW Spring collection of sandals from Orthaheel are in both for Men and Women. Come in today and pick out a new pair to start off your season right!

Whether you are an existing patient or searching for a podiatrist in the Jacksonville area, we're excited you are here. With the podiatry industry advancing, we recognize the importance of keeping our patients and visitors up to date with all of the new and exciting things taking place in our practice.

As we move forward with our blog, we hope to promote podiatric awareness as a vital part of your healthy, active lifestyle. Here you will find a variety of articles and topics including the latest developments in podiatry, podiatric treatments and helpful foot care advice from Dr. Reddy and his/her staff.

We hope you find our blog to be helpful, engaging and informational to ensure the long-term health of your feet.

As always, feel free to contact us with any questions or concerns.

-- The First Coast Foot and Ankle Clinic Team