Don’t let foot injuries keep you from your fitness resolutions 

In the New Year, don’t forget to keep your feet in tip-top shape while following through with your resolutions to get fit. Indianapolis foot and ankle surgeon Scott Neville, DPM, FACFAS, offers tips for foot safety while at the gym.  

Start new workouts gradually— Increase your stamina and the length of your workouts gradually to avoid overuse injuries such as stress fractures or tendon strains and sprains. Stretching your muscles before and after workouts also helps prevent these types of injuries. “If you do feel you’ve sprained your ankle, be sure to seek treatment right away,” Dr. Neville, a member of the American College of Foot and Ankle Surgeons explains. “Untreated or repeated ankle sprains may lead to chronic ankle instability, a condition that causes persistent pain and a ‘giving way’ of the ankle.”

Wear the right shoe and sock—Wear well-fitting athletic shoes designed for the exercise or sport. According to Dr. Neville, shoes that don’t support the arch of the foot and provide cushion for the heel can cause heel pain (plantar fasciitis). Shoes that are too small can also cause a neuroma, or a thickening of the nerve tissue, in the foot and may require injections, medication or physical therapy. Wearing cotton or non-slip socks are also key to help avoid painful blisters, which can become infected and cause more serious issues.

Use good technique— Improper exercise techniques can result in injury to the tendons or ligaments in your feet and ankles. “Incorrect posture or misuse of exercise equipment can cause decreased stabilization in the foot and ankle, leading to joint sprains and muscle strains,” Dr. Neville says.

Protect yourself from bacteria—Sweaty shoes, public showers, exercise equipment and the pool deck at the gym are breeding grounds for fungus, viruses and bacteria, including drug-resistant strains like MRSA (methicillin-resistant Staphylococcus aureus) which has become increasingly more common. Never go barefoot while in public areas; water shoes can provide a great barrier between your feet and the wet surfaces. “It’s also best to cover cuts and cracks in the skin or ingrown toenails since these minor tears in the skin’s surface can act as entry points for bacteria. If you have a cut or scrape that becomes red or swollen and is not healing in a timely manner, don’t hesitate to see a foot and ankle surgeon for an examination,” Dr. Neville says.

Above all, it’s important to listen to your body. If you experience an injury or pain, call Dr. Neville’s office at 

317-834-5777 for an evaluation. To learn more about foot and ankle health topics, visit the American College

of Foot and Ankle Surgeon’s website, FootHealthFacts.org.

Keep Feet Healthy While Running

Do you love running, but hate those injuries that keep you sidelined? Well, there is research that by striking your forefoot first, versus heel first, you may experience less repetitive stress injuries. In fact, it may be as high as a 40 percent reduction in injuries. According to Daniel Lieberman, PH.D., study coauthor and a human evolutionary biologist at Harvard University, "Theoretically, this is because heel-striking sends forces up to three times your weight through your body, while the impact when your forefoot hits is barely measurable." Follow these 4 important steps to stay injury free:

1) Keep a slight bend in your knee, since touching down with a stiff leg increases the force of impact.

2) Take short, fast strides. Your goal should be 165 steps per minute. To do this, bend your back knee more than usual, and don't let your rear leg stay behind for too long.

3) Make sure your foot is lined up with your hip when your foot hits the ground.

4) Land on the outer ball of your foot and angle your foot slightly down. After your forefoot hits, let the heel of your foot touch down naturally.

The Shape Magazine August 2012 issue has more information on this study and running technique. 

For more information on foot conditions that affect athletes, contact Dr. Scott Neville 's office at 317-834-5777.

For Many, Winter is Fall Season

Icy conditions cause falls and broken ankles every winter in Indianapolis. With the hectic pace of the holidays, serious injuries from ice-related falls inevitably occur. An indianapolis foot and ankle surgeon says falls on icy surfaces are a major cause of ankle sprains and fractures, and it’s critical to seek prompt treatment to prevent further damage that can prolong recovery. Scott M. Neville, DPM, FACFAS says the ankle joint is vulnerable to serious injury from hard falls on ice.“Ice accelerates the fall and often causes more severe trauma because the foot can go in any direction after slipping," he says. Dr. Neville is a member of the American College of Foot and Ankle Surgeons (ACFAS) with offices in Mooresville and Plainfield Indiana. He adds that in cases of less severe fractures and sprains, it’s possible to walk and mistakenly believe the injury doesn’t require medical treatment. “Never assume the ability to walk means your ankle isn’t broken or badly sprained," he says. "Putting weight on the injured joint can worsen the problem and lead to chronic instability, joint pain and arthritis later in life."Some people may fracture and sprain an ankle at the same time, and a bad sprain can mask the fracture. “It’s best to have an injured ankle evaluated as soon as possible for proper diagnosis and treatment,” says Dr. Neville. “If you can’t see a foot and ankle surgeon or visit the emergency room right away, follow the RICE technique – Rest, Ice, Compression and Elevation – until medical care is available.”According to the ACFAS consumer Web site, FootPhysicans.com, even though symptoms of ankle sprains and fractures are similar, fractures are associated with: Pain at the site of the fracture that can extend from the foot to the kneeSignificant swellingBlisters over the fracture siteBruising soon after the injuryBone protruding through the skin—a compound fracture, which requires immediate attention!Most ankle fractures and some sprains are treated by immobilizing the joint in a cast or splint to foster union and healing. However, surgery may be needed to repair fractures with significant malalignment to unite bone fragments and realign them properly. Dr. Neville said newly designed surgical plates and screws allow repair of these injuries with less surgical trauma. “With newer bone-fixation methods, there are smaller incisions to minimize tissue damage and bleeding and accelerate the healing process,” he says. Dr. Neville recommends scheduling an appointment with his office if you have injured your ankle in any way.“If you fall on an icy spot and hurt your ankle, the best advice is to seek medical attention immediately," He says. "This aids in early diagnosis and proper treatment of the ankle injury and reduces the risk of further damage.”For further information about ankle fractures and sprains or other foot and ankle problems, contact Dr. Neville at 317-834-5777.

Golfers: Don't Be Handicapped with Foot Pain

As millions of avid golfers get ready for another season of pars and bogeys, they should be aware of potentially serious foot problems that can result from years of playing the game.
Although golf is not considered a rigorous sport, the physical act of repeatedly swinging a golf club in practice and on the links can lead to a condition known as hallux limitus, a jamming and deterioration of the big toe joint.
According to Dr. Scott M. Neville, the movement and weight transfer that occur during the swing’s follow through can cause this problem and other chronic foot ailments. Dr. Neville is a fellow of the American College of Foot and Ankle Surgeons with offices in Mooresville and Plainfield Indiana.
“When golfers follow through on their swing, they can overextend the big toe joint on the back foot,” says Dr. Neville. “Those who have played the game avidly for several years eventually can wear out the cartilage or jam the big toe joint. The likely outcome, if left untreated, is painful arthritis in the big toe, which would make it very difficult to continue playing golf.”
Golfers who have pain and swelling around the big toe joint or have less mobility in this area than other parts of the foot should visit a foot and ankle surgeon for an examination and appropriate treatment. A history of trauma to the big toe area and bone structure also can precipitate the condition. Individuals with a long first metatarsal bone (big toe), for example, are more susceptible to joint compression and hallux limitus.
“If golfers experience pain in the big toe area when playing, they should consider it a warning sign that intervention is necessary before the joint becomes arthritic,” says Dr. Neville “In most situations, orthotics can be prescribed to provide relief, but others with advanced cases may require surgery.”
Another foot problem that is common in golfers is a neuroma or pinched nerve at the bottom of the foot. The weight transfer to the front foot that occurs in the follow through applies pressure that, over time, can cause a pinched nerve.
Dr. Neville also advises golfers not to wear shoes that have a spike located directly beneath the ball of the foot.
“The pressure from that single spike, magnified by the several thousand steps taken during an average round, can cause intense pain and swelling in the ball of the foot,” he says.
Dr. Neville says any pair of golf shoes can be made more foot friendly without sacrificing traction by removing the poorly located spikes.
For more information on foot conditions that affect athletes, contact Dr. Scott Neville 's office at 317-834-5777.

Soccer Season is Prime Time for Foot & Ankle Injuries

Soccer season is in full swing and a local foot and ankle surgeon strongly urges parents and coaches to think twice before coaxing young, injury-prone soccer players to “play through” foot and ankle pain.
“Skeletally immature kids, starting and stopping and moving side to side on cleats that are little more than moccasins with spikes – that’s a recipe for foot and ankle sprains and worse,” cautions Dr. Scott Neville a member of the American College of Foot and Ankle Surgeons.
“Kids will play with lingering, nagging heel pain that, upon testing, turns out to be a stress fracture that neither they, their parents nor their coaches were aware of,” he said. “By playing with pain, they can’t give their team 100 percent and make their injuries worse, which prolongs their time out of soccer.”
Dr. Neville said he has actually had to show parents x-rays of fractures before they’ll take their kids out of the game. “And stress fractures can be subtle – they don’t always show up on initial x-rays.”
Symptoms of stress fractures include pain during normal activity and when touching the area, and swelling without bruising. Treatment usually involves rest and sometimes casting. Some stress fractures heal poorly and often require surgery, such as a break in the elongated bone near the little toe, known as a Jones fracture.
“Soccer is a very popular sport in our community, but the constant running associated with it places excessive stress on a developing foot,” Dr. Neville said. He added that pain from overuse usually stems from inflammation, such as around the growth plate of the heel bone, more so than a stress fracture. “Their growth plates are still open and bones are still growing and maturing – until they’re about 13 to 16. Rest and, in some cases, immobilization of the foot should relieve that inflammation,” Dr. Neville said.
Other types of overuse injuries are Achilles tendonitis and plantar fasciitis (heel pain caused by inflammation of the tissue extending from the heel to the toes).
Quick, out-of-nowhere ankle sprains are also common to soccer. “Ankle sprains should be evaluated by a physician to assess the extent of the injury,” said Dr. Neville. “If the ankle stays swollen for days and is painful to walk or even stand on, it could be a fracture."
Collisions between soccer players take their toll on toes. “When two feet are coming at the ball simultaneously, that ball turns into cement block and goes nowhere. The weakest point in that transaction is usually a foot, with broken toes the outcome,” he/she explained. “The toes swell up so much the player can’t get a shoe on, which is a good sign for young athletes and their parents: If they are having trouble just getting a shoe on, they shouldn’t play.”

Frequently Asked Questions About Diabetes and the Feet

As the leading cause of non-traumatic, lower-limb amputations, diabetes is reaching epidemic proportions, now more than ever. It can have a devastating impact on the body, affecting numerous parts of the body including the eyes, mouth and feet. In fact, the feet, often overlooked at routine checkups, can reveal the first signs and symptoms of the disease. All too often, patients forget to take off their shoes and socks and ask their health care providers to inspect their feet. Close to 24 million people in the United States have diabetes and nearly 6 million people have it and do not even know it. That’s why it’s important to elect to save your feet whether you have the disease or not. Know the signs and symptoms of diabetes and have your feet checked every time you visit the doctor.

1. Why should I ask my doctor to take off my shoes and socks?The feet, said to be mirrors of our general health, can reveal diabetes warning signs such numbness, redness, swelling or non-healing wounds. Taking off your shoes and socks at every doctor’s visit is critical to the prevention and treatment of systemic diseases such as diabetes.

2. Who is at risk for diabetes?While many Americans are predisposed to have the disease based on family history, Hispanics, African Americans, American Indians, Asian Americans and Pacific Islanders are more at risk. People with type 2 diabetes can do a great deal to lower their chances of getting the disease such as exercising regularly, reducing fat and calorie intake and losing weight.

3. What can happen if diabetes is not detected in its early stages?Many people do not find out they have the disease until they develop serious complications such as foot ulcers. In fact, six million Americans with diabetes have not been diagnosed. The good news is that diabetes, although serious, can be managed. However, if left undiagnosed or untreated, it can damage the body and result in long-term complications such as lower-limb amputations, cardiovascular disease, stroke, blindness and kidney disorders.

4. I have been diagnosed with diabetes. What type of foot complications could I possibly experience?You may experience the following symptoms:
- a loss of feeling in your feet.
- a change in the shape of your feet.
- foot ulcers or sores that do not heal.
Keeping your blood glucose (sugar) in good control and taking care of your feet every day can help you avoid serious foot problems.

5. Should I see a podiatrist if I have diabetes?Treating diabetes requires a team approach. A podiatrist is an integral part of the treatment team, and a yearly exam is appropriate to ensure proper pedal care. Your primary care doctor may refer you to other health care professionals including a dietitian, nurse educator, dentist, eye doctor and an exercise physiologist to help you manage the disease.

For additional questions or treatment, contact Dr. Scott Neville at the Foot & Ankle Center in Mooresville and Plainfield, Indiana at 317-834-5777.

AMPUTATION PREVENTION BEGINS WITH ‘ELECTING TO SAVE YOUR FEET’

With nearly 246 million people across the globe battling diabetes and its complications this year, staying one step ahead of the disease has never been more important. As America’s political landscape reaches an exciting culmination with November’s 2008 Presidential election, it’s also important to remember to “Elect to Save Your Feet!” More than 60 percent of non-traumatic, lower-limb amputations in the United States occur among people with diabetes. Because of this, the American Podiatric Medical Association (APMA) is launching a national campaign titled “Elect to Save Your Feet.” This campaign, run during Diabetes Awareness Month in November, aims to educate the public about the importance of seeing a podiatrist regularly to prevent diabetic, lower limb amputations.

“Getting your feet examined by a physician during an annual checkup is one of the easiest ways to prevent most foot complications related to diabetes,” said Dr. Ross Taubman, president of the APMA. “The rate of amputation for those with diabetes is 10 times higher than those without the disease. Being vigilant in your personal footcare, and including your podiatrist in your diabetes management team, can save both your limbs and your life.”

Every 30 seconds, a lower limb is lost to diabetes somewhere in the world. Those with diabetes are more prone to develop foot infections, called foot ulcers, which can quickly result in amputation. Preventing amputation means knowing all of the main warning signs. Other common diabetes warning signs in the feet besides ulcers include:

· A tingling or loss of feeling in the feet
· Redness
· A change in the shape of the feet
· Loss of hair
· Cuts and scrapes that are slow to heal

If you discover any of these symptoms, visit a podiatric physician immediately. A comprehensive foot care treatment plan can reduce amputation rates by 45 percent to 85 percent. Including a podiatrist in your diabetes management team – as well as having a proactive attitude about your footcare – can drastically improve your chances of managing diabetes successfully.

For more information on the warning signs of diabetic ulcers, and to learn the best way that you can “Elect to Save Your Feet,” visit www.apma.org/diabetes.

Founded in 1912, the American Podiatric Medical Association is the nation's leading professional society for foot and ankle specialists. The association has component societies in 53 locations in the U.S. and its territories and a membership of close to 11,500 doctors of podiatric medicine. For free foot health information, visit http://www.apma.org/.

For additional questions or treatment, contact Dr. Scott Neville at the Foot & Ankle Center in Mooresville and Plainfield, Indiana at 317-834-5777.