Fall season is fast approaching.  

Autumn is a painful time of year for many New York women.

As they transition from open-toed sandals to closed-in boots and shoes, I notice more women seeking relief for painful bunions.
Some of my female bunion patients are in agony. They describe a constant, throbbing pain, even when they take their shoes off.

While the changing weather brings more bunion patients into my office, some women inquire about surgery in the fall because they’re less busy than in summer months. Many are also closer to meeting their insurance deductibles.

I emphasize that surgery is a last-resort treatment for women with painful bunions.

For many women, simple changes like wearing shoes with wider toe boxes can significantly reduce bunion pain. Custom shoe inserts, gel- or foam-filled padding and anti-inflammatory medications may also provide pain relief.

When the pain of a bunion interferes with a woman’s daily activities, it’s time to discuss surgical options.

Glenn J Donovan, DPM

Dr. Donovan is the Chief of Podiatry at Coney Island Hospital.

For more information on  foot problems  please contact Dr. Donovan at 718-616-5509

In previous blogs I talked about general shoe fitting for children.  With kids back in school after a summer of bare feet and sandals, parents are shopping for shoes for feet that seem to have grown longer in just a few months.  To help busy parents with shoe choices, I recommend some simple guidelines to prevent or minimize possible foot problems from inappropriate shoes, such as painful ingrown toenails, blisters, heel pain and flat feet.

When choosing kids’ shoes, size and shock absorption are the key considerations, especially if your child has flat feet that can worsen from improper fitting or worn-out shoes. Also, a child’s foot can grow a size or two within six months, so it’s critical to allow room for growth in the toe box—about a finger’s width from the longest toe.” 

Snug shoes put pressure on the toes, causing ingrown nails. The nail compresses and grows down into the skin. Infection can occur when an ingrown nail breaks through the skin.

If there’s pain, redness and fluid draining from the area, it’s probably infected. The ingrown nail can be removed in a simple, in-office procedure. Don’t try to remove a child’s ingrown nail at home; this can cause the condition to worsen.

Tight-fitting shoes also cause blisters, corns and calluses on the toes and blisters on the back of the heels.

I recommend never buy shoes that feel tight and uncomfortable in the store. Don’t assume they will stretch or break in over time. 

Conversely, that shoes that are too loose can cause problems, too. 

If a shoe is too loose, the foot slides forward and puts excessive pressure on the toes.

I also recommend parents carefully inspect both new and old shoes to check for proper cushioning and arch support. 

Shoes lose their shock absorption over time, and wear and tear around the edges of the sole usually indicate it’s worn out and should be replaced. If a child keeps wearing worn-out or non-supportive dress or athletic shoes, it elevates the risk for developing heel pain, Achilles tendonitis and even ankle sprains and stress fractures.

A good tip for parents when buying new shoes: The toe box should flex easily and the shoe shouldn’t bend in the middle of the sole.

For children with flat feet, parents should buy oxford, lace-up shoes that have enough depth for an orthotic insert, if necessary. 

Unfortunately, there isn’t much choice for kids with flat, wide feet. They need shoes with a wide toe box and maximum arch support and shock absorption. Slip-on loafers aren’t right for them.

Glenn J Donovan, DPM

Dr. Donovan is the Chief of Podiatry at Coney Island Hospital.

For more information on  foot problems  please contact Dr. Donovan at 718-616-5509

Simple at-home checks help spot foot problems

Back to school season is getting underway. I have included some advice for area parents.

Take five minutes to inspect your children’s feet for problems that could sideline your son or daughter from sports or other activities.

Parents should look for these warning signs:

Do the bottom of the child’s shoes show uneven wear patterns?

Does the child walk irregularly? Is one leg longer than the other or do feet turn in or out excessively?

Do pre-schoolers walk on their toes?

Does the child often trip or stumble?

Does the child complain of tired legs, night pains and cramping?

Following this checklist can uncover common problems like ingrown toenails to more serious problems like flat feet. If your child’s shoe is worn on the big toe side of their foot, it could be a sign of poor arch support or flat feet.”

I tell the parents of my Pediatric patients that they  can spot several potential foot problems by observing how their kids walk.

If you find out one of your child’s legs is longer than the other, heel lifts may be required to restore proper balance..

Early intervention can prevent scoliosis, a curvature of spine, later in life.

Sometimes younger children toe-walk because of tightness in their Achilles tendon. This  can happen when toddlers spend too much time in walkers.

I recommend stretching exercises that can be fun for small children and help prevent lower back pain as they get older. For older children beginning college, heel pain and shin splints can plague freshmen not used to walking long distances across campus to attend classes.

I see students every autumn complaining about pain from walking so much everyday. For most students, daily stretching and proper walking shoes can solve the problem. If there are foot deformities like hammertoes, surgery may be advised to make walking more comfortable.  “Growing pains” are a myth.

If your kids complain about tired legs, heel pain or leg or foot cramps at night, consider that a warning sign and see a doctor. Leg and foot pain can indicate flat feet or other disorders that are easier to treat the earlier they’re diagnosed.

Children with flat feet are at risk for arthritis later in life if the problem is left untreated.

Glenn J Donovan, DPM

Dr. Donovan is the Chief of Podiatry at Coney Island Hospital.

For more information on  foot problems  please contact Dr. Donovan at 718-616-5509

Shoes are the best way to protect your family’s feet from injuries. But if your summer just wouldn’t be the same without kicking off your shoes or sandals, you can still make it a safe season.

I offer these tips for a safer barefoot summer:

–See a foot and ankle surgeon within 24 hours for a puncture wound.

Why: These injuries can embed unsterile foreign objects deep inside the foot. A puncture wound must be cleaned properly and monitored throughout the healing process. This will help to avoid complications, such as tissue and bone infections or damage to tendons and muscles in the foot. Foot and ankle surgeons are trained to properly care for these injuries.

–Make sure you’ve been vaccinated against tetanus. Experts recommend teens and adults get a booster shot every 10 years.

Why: Cuts and puncture wounds from sharp objects can lead to infections and illnesses such as tetanus.

–Apply sunscreen to the tops and bottoms of your feet.

Why: Feet get sunburn too. Rare but deadly skin cancers can develop on the feet.

–Inspect your feet and your children’s feet on a routine basis for skin problems such as warts, calluses, ingrown toenails and suspicious moles, spots or freckles.

Why: The earlier a skin condition is detected, the easier it is for your foot and ankle surgeon to treat it.

–Wear flip-flops or sandals around swimming pools, locker rooms and beaches.

Why: To avoid cuts and abrasions from rough anti-slip surfaces and sharp objects hidden beneath sandy beaches, and to prevent contact with bacteria and viruses that can cause athlete’s foot, plantar warts, and other problems.

–Use common sense.

Why: Every year, people lose toes while mowing the lawn barefoot. Others suffer serious burns from accidentally stepping on stray campfire coals or fireworks. Murky rivers, lakes and ponds can conceal sharp objects underwater. People with diabetes should never go barefoot, even indoors, because their nervous system may not “feel” an injury and their circulatory system will struggle to heal breaks in the skin.

Glenn J Donovan, DPM

Dr. Donovan is the Chief of Podiatry at Coney Island Hospital.

For more information on  foot problems  please contact Dr. Donovan at 718-616-5509

Coney Island Hospital is surronded by the most popular beaches in Brooklyn.  There are 3 within walking distances:  Coney Island, Brighton and Manhattan Beaches. Hence the Podiatry Department sees many beach related injuries. As millions of Americans hit the beach this summer, I’d like to share these safety tips:

Puncture wounds and cuts: Wear shoes to protect your feet from puncture wounds and cuts caused by sea shells, broken glass and other sharp objects. Don’t go in the water if your skin gets cut – bacteria in oceans and lakes can cause infection. To avoid complications from a puncture wound, see a foot and ankle surgeon for treatment within 24 hours.

Jellyfish stings: Remember that a jellyfish washed up on the beach can still sting if you step on it. If their tentacles stick to the foot or ankle, remove them, but protect your hands from getting stung too. Vinegar, meat tenderizer or baking soda reduce pain and swelling. Most jellyfish stings heal within days, but if they don’t, medical treatment is required.

Sunburns: Feet get sunburn too. Rare but deadly skin cancers can occur on the foot. Don’t forget to apply sunscreen to the tops and bottoms of your feet. 

Burns: Sand, sidewalks and paved surfaces get hot in the summer sun. Wear shoes to protect your soles from getting burned, especially if you have diabetes.

Ankle injuries, arch and heel pain: Walking, jogging and playing sports on soft, uneven surfaces like sand frequently leads to arch pain, heel pain, ankle sprains and other injuries. Athletic shoes provide the heel cushioning and arch support that flip-flops and sandals lack. If injuries occur, use rest, ice, compression and elevation to ease pain and swelling. Any injury that does not resolve within a few days should be examined by a foot and ankle surgeon.

Diabetes risks: The 20 million Americans with diabetes face serious foot safety risks at the beach. The disease causes poor blood circulation and numbness in the feet. A diabetic may not feel pain from a cut, puncture wound or burn. Any type of skin break on a diabetic foot has the potential to get infected and ulcerate if it isn’t noticed right away. Diabetics should always wear shoes to the beach, and remove them regularly to check for foreign objects like sand and shells that can cause sores, ulcers and infections.

Glenn J Donovan, DPM

Dr. Donovan is the Chief of Podiatry at Coney Island Hospital.

For more information on  foot problems  please contact Dr. Donovan at 718-616-5509

Many of the estimated 70 million obese Americans are trapped in a life-threatening vicious cycle:  Obesity aggravates foot problems, like heel pain and flat feet; sore feet make it hard to exercise and lose weight; and without exercise, obesity worsens and exacerbates progression of diabetes, heart disease and other serious health threats. I urge obese adults to seek immediate treatment for chronic, activity-limiting foot and ankle problems to foster compliance with physician-directed exercise programs.

It’s unfortunate obese adults get caught up in the vicious cycle of avoiding physical activity due to foot or ankle pain, thereby permitting cardiovascular disease and other life-threatening conditions to worsen as a result. In many cases, chronic heel pain occurs from carrying too much weight.  Left untreated, it becomes an impediment to physical activity and meaningful weight loss.” 

There’s no reason foot or ankle pain should stop obese patients from exercising. The first step toward breaking that vicious cycle is an evaluation by a foot and ankle surgeon. 

Many causes of foot pain can be relieved without surgery through stretching exercises, orthotics and athletic shoes with good shock absorption and support. If a bunion, heel pain or other condition requires surgery, patients can participate during their recovery in non-weight-bearing activities, such as riding a stationary bike, swimming or weight training. 

For those moderately to severely overweight, thorough physical examination is mandatory before beginning an exercise program. 

Once cleared by your physician to begin exercising, don’t try to do too much too soon.  Follow a gradual routine until your body adjusts to the stress of regular physical activity. For example, I counsel overweight patients to avoid working out on treadmills or elliptical machines to minimize pounding and stress on their joints.”  

Shedding excess pounds helps diabetic patients control their disease, but many who experience foot ulcerations and vascular problems caused by diabetes might think they shouldn’t exercise. 

Every diabetes patient needs regular foot exams to check for possible sore spots and assess nerve sensation. And with proper diabetic foot care and the right footwear, most patients can follow an exercise regimen that is safe and appropriate for them.

Glenn J Donovan, DPM

Dr. Donovan is the Chief of Podiatry at Coney Island Hospital.

For more information on  foot problems  please contact Dr. Donovan at 718-616-5509

An estimated 16 percent of U.S. children ages six to 19 are overweight, according to the Centers for Disease Control and Prevention. Poor  diet, lack of exercise and genetics can play a role.  A “vicious cycle’ of foot pain and obesity traps some children.

 You want overweight children to exercise and lose weight, but because of their weight, their feet hurt and they can’t exercise.

 The foot is a complex structure consisting of 26 bones, 33 joints and more than 100 muscles, tendons and ligaments. Recently researchers in Britain reported “alarming new evidence that childhood obesity changes foot structure and results in instability when walking.” Being overweight flattens the foot, straining the plantar fascia, a band of tissue which runs from the heel to the base of the toes, causing heel pain.

 Because the heel bone is not fully developed until age 14 or older, overweight children are more prone to Sever’s disease. Although not an actual disease, it involves an inflammation of the heel’s growth plate due to muscle strain and repetitive stress. Walking makes the pain worse. Being overweight may also cause stress fractures, or hairline fractures (breaks) in a child’s heel bone.

 Some overweight children suffer foot pain from congenital or inherited foot conditions, such as bunions, hammertoes, pediatric flatfoot and tarsal coalition, an abnormal connection between two or more bones in the back of the foot. Children with these deformities may be less active because of pain.  Sometimes a child will complain of calf or arch pain. This results from a flatfoot that is flexible. The collapsing of the arch can require more energy, making it more difficult for a child to walk and run.

 Foot and ankle surgeons treat many overweight children with custom orthotic devices (shoe inserts), physical therapy and other conservative measures to reduce or eliminate pain. But treating painful feet and ankles is only part of the childhood weight loss equation.

 As foot and ankle surgeons, we can reduce the aches and pains so these children can run around and play like all the other kids, but parents need to take responsibility for watching their children’s’ lifestyles and diets.

Glen  J. Donovan, D.P.M.

Dr. Donovan is the Chief of Podiatry at Coney Island Hospital.

For more information on  foot problems  please contact Dr. Donovan at 718-616-5509.

The barrier to a perfect golf swing could lie in your big toe. Or your heel. Or on the ball of your foot. These are the three areas of your feet most likely to cause pain that can ruin your golf swing.

Behind these pain-prone spots can lie stiff joints, stretched-out tissues and even nerve damage. But pain relief is possible and frequently does not require surgery.

The three most common painful foot conditions that can ruin your golf swing are heel pain, arthritis and pinched nerves.

• Arthritis can cause pain in the joint of your big toe that makes it difficult to follow-through on your golf swing.

• Heel pain typically results from an inflammation of the band of tissue that extends from your heel to the ball of your foot. People with this condition compare the pain to someone jabbing a knife in their heel. Heel pain can make it uncomfortable for golfers to maintain a solid stance during crucial portions of their golf swing.

• Neuromas are nerves that become thickened, enlarged and painful because they’ve been compressed or irritated. A neuroma in the ball of your foot can cause significant pain as your body transfers its weight from one foot to the other in a golf swing.

Several other painful conditions can also cause instability during your swing. Some athletes and former athletes develop chronic ankle instability from previous ankle sprains that failed to heal properly. Motion-limiting arthritis and Achilles tendonitis can also affect your balance. Ill-fitting golf shoes may cause corns and calluses that make standing uncomfortable.

For the majority of golfers and other patients I recommend simple treatments such as custom orthotic devices (shoe inserts), stretching exercises, changes to your shoes, medications, braces or steroid injections and physical therapy. However, if these conservative measures fail to provide adequate relief, surgery may be required.

Remember foot pain is not normal. With the treatment options available to your foot and ankle surgeon, a pain-free golf swing is clearly in view. When your feet aren’t in top condition, your golf swing won’t be either.

Glen Donovan, D.P.M.

Dr. Donovan is the Chief of Podiatry at Coney Island Hospital.

For more information on  foot problems  please contact Dr. Donovan at 718-616-5509.

Parents can prevent a common childhood foot problem by following some simple recommendations.

Ingrown toenails are one of the most frequent conditions I treat in children. Many kids hide their ingrown toenails from their parents, even though the condition can cause significant pain. An ingrown nail can break the skin and lead to dangerous infections.

This condition is caused by tight shoes, tight socks and incorrect nail trimming for most cases. In others, the children may inherit the tendency for nails to curve. American College of Foot and Ankle Surgeons suggests that parents would do the following:

Teach children how to trim their toenails properly. Trim toenails in a fairly straight line, and don’t cut them too short.

Make sure children’s shoes fit. Shoe width is more important than length. Make sure that the widest part of the shoe matches the widest part of your child’s foot.

If a child develops a painful ingrown toenail, reduce the inflammation by soaking the child’s foot in room-temperature water and gently massaging the side of the nail fold.

The only proper way to treat a child’s ingrown toenail is with a minor surgical procedure at a doctor’s office. After the surgery I may also prescribe antibiotics to children with infected ingrown toenails. Parents should never try to dig the nail out or cut it off. These dangerous “bathroom surgeries” carry a high risk for infection.

Glen Donovan, D.P.M.

Dr. Donovan is the Chief of Podiatry at Coney Island Hospital.

For more information on  foot problems  please contact Dr. Donovan at 718-616-5509.