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Mountain West Foot & Ankle Institute Mountain West Foot & Ankle Institute
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What Questions Do You Have?

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  • I take a lot of pills for my diabetes. Is there a neuropathy treatment available that won't interfere with these?

    Yes. Diabetics often take multiple medications to manage their diabetes.  There are several oral medications you can take that don't interfere with most diabetic drugs, but there are also other options that may be even easier.

    LASER treatment These treatments work by reducing pain and stimulating the area, which is important if cells are starting to lose function.  

    Topical gels These are used mostly as pain managers.  Applied to the skin, these gels/creams can target the painful area and very little of the medication is absorbed into the bloodstream.

    Nutritional supplements Depending on the cause of your neuropathy, nutritional supplements can effectively improve neuropathy without interfering with drugs, since they are already present to some degree inside your body.

    Essential oils These work similarly to topical pain relief gels.  They are used externally and do not interfere with medications.


  • My doctor said there's no cure for neuropathy. Do I just have to suffer?

    No!  Many patients are very discouraged about their neuropathy when they come into our office because they have been told this before. However, there are actually a wide variety of treatments that help neuropathy patients!  There are some things to consider when learning about neuropathy treatment options:

    1. There are many causes of neuropathy. For some people, it's a simple nutrient deficiency.  Once that is corrected, nerve function improves drastically. Other cases can be more complicated and treatment options will be more focused on slowing progression and managing pain rather than returning nerves to their perfect function.

    2. The symptoms of neuropathy vary from patient to patient.  For some, it can be very painful.  In those cases, we'd be focusing on sustainable ways to decrease pain.  For others, neuropathy is not painful but is more about a loss of function.  Those patients would have different treatment if pain is not the main issue.

    3. There are many treatments available for neuropathy. Just because you have tried one treatment, doesn't mean you should give up hope.  There are lots of effective options when it comes to treating neuropathy.  The Gibson Method used all over the country originated in our office from our very own Dr. Brandt Gibson.  He is an expert at methodically checking for causes of peripheral neuropathy and prescribing effective treatment.

    4. Not every office offers the same treatments. Some treatments that we offer in our office are not offered in other offices.  We stay on the cutting edge of treatments so that we can see the most improvement among our patients.  Similarly, we may not offer some treatments because they have been found to be ineffective compared with other options.  If you have questions, please call our helpful staff for information.

  • How do I know if I have diabetes?

    You can have your fasting blood glucose tested at your primary care physician's office.  A fasting blood glucose level of 126 mg/dl or higher is indicative of diabetes. 


    Symptoms of diabetes include:

    Frequent urination

    Frequent thirst

    Extreme hunger even if you are eating

    Slow healing wounds


    If you are experiencing any of these symptoms, schedule a visit with your physician. 

    Check here for info on pre-diabetes.

  • How do I know if I have pre-diabetes?

    You can be tested for pre-diabetes at your primary care physician's office.  It will include fasting for a certain time period before your appointment, then having a blood test to determine your blood glucose.  Having a fasting blood glucose level of between 100-125 mg/dl would be indicative of pre-diabetes.


    Check our other FAQ for more information on symptoms and testing of diabetes.

  • Is my heel pain from a bone spur or plantar fasciitis?

    Many patients come into our office asking about treatment for painful bone spurs.  A bone spur is a little outgrowth of bone.  They can occur anywhere, but people usually complain of them being painful in the heel. 

    We do see cases of bone spurs, but usually, bone spurs are painless.  Most people with bone spurs on their heels walk around with no pain.  Usually, the real problem is plantar fasciitis, not bone spurs. 

    Plantar fasciitis occurs when the fascia (muscle/ligament lining) on the plantar (bottom) area of the foot is inflamed.  It gets continually stretched and strained because it is too short and becomes dysfunctional and very painful.

    So how do you know what is causing your pain? 

    • One of the hallmark signs of PF is intense pain with the first few steps out of bed in the morning.  This is due to the plantar fascia trying to heal during the night and immediately getting strained upon being stretched in the morning. 
    • A quick digital X-ray in our office can detect the presence of bone spurs as a potential source of pain
    • Trying special stretches and moderate treatment can improve pain from plantar fasciitis, but would have no effect if the problem was really bone spurs.

  • How Many MSL LASER Treatments Are Needed?

    This video explains how many MSL LASER treatment sessions are typically needed.

  • How Does MLS LASER Therapy Work?

    MLS Laser Therapy stimulates healing and stops inflammation pathways at the cellular level. This video explains how.

  • I Work During the Day, Do You Offer Late/Early Hours?

    Yes, we do!  Many of our patients work full time and take advantage of our early and late days.  We also rotate the hour we are closed for lunch, so you can stop by on your lunch break. 

    Our hours:

  • Can I Go Swimming After Ingrown Toenail Surgery?

    You can go swimming 24 hours after having an ingrown toenail removed.  Just remove the bandage from surgery soak/apply Amerigel and put on a small peice of gauze and a Band-aid.  Then go swimming as usual, pools and lakes are just fine.  You may want to wear water shoes for added protection.  Be sure to soak/apply Amerigel and fresh gauze and Band-aid promptly after swimming.

  • How does Biofreeze work?

    From the Biofreeze website: "Biofreeze products are classified as topical analgesics, which work through a ‘counter irritant’ mechanism. This means that the menthol in Biofreeze creates a sensation that overrides pain signals to the brain. This process is known as ‘Gate Control Theory’, where nerve impulses from one stimulus block the nerves containing pain signals to the brain. Recent research also suggests that menthol may stimulate cold receptors in the skin that may help regulate pain as well."

    Biofreeze blocks pain receptors so that your nerves don't percieve pain.  Decreasing pain is important to us, and this is one effective way to do it.  Talk to your doctor about how to use biofreeze or other topical analgesics in conjunction with RICE thereapy, anti-inflammatory medication (such as ibuprofen) and other pain relievers.

  • Will my ingrown toenail come back?

    No.  If you get your ingrown treated in our office, Dr. Gibson can treat the affected area of the nail bed so that ingrowns won't come back.  This is nice because usually ingrown toenails are genetic and so if you get one, you tend to keep getting them your whole life.  Wearing appropriate shoes and clipping your toenails straight across also help prevent ingrown recurrance.

  • How do you fit pointe shoes?

    If this is your first pair of pointe shoes, going into a  dance store or studio is often the best way to make sure you get the proper fit and the right shoes for your needs. Here are some guidelines that will help you find the right shoe:

    1. Toes should lie flat in the shoe (they shouldn't overlap)
    2. Just the big toe should touch the top of the box when you stand.  If it doesn’t touch, the shoe is to long, if all your toes touch the box, the shoe is too short. (If all toes slide down and touch only when en pointe, the shoe is too big.)
    3. The shoe should have strong shank.  The shank of the shoe will assist in supporting dancing en pointe, especially if you have a very flexible arch.
    4. If you can slip a finger between your foot and the drawstring, the shoe is too wide.
    5. Flex your foot.  If your heel is pinched painfully, the shoe is too tight.

  • What are some ways to protect my feet once I am dancing en pointe?

    1. Treat blisters immediately as they form.  Popping blisters can relieve pain and pressure and keep it small.  You don’t want the blister to pop inside your shoe.  To pop a blister:
      1. Clean the area thoroughly with soap and water.
      2. Disinfect the needle with rubbing alcohol.
      3. Insert the needle at the base of the blister.  This will leave a protective covering on the vulnerable spot and reduce chances of infection.
      4. Allow the fluid to drain, applying slight pressure to help the fluid flow out.
      5. Apply a bandaid or moleskin to the area to reduce the rubbing that created the blister.
    2. Tape the toes or using moleskin patches can help to protect them from rubbing inside the shoe.
    3. Keep toenails trimmed short and straight across.
    4. Some dancer will use gel or lamb’s wool padding in their pointe shoes, but others feel it may interfere with the feel of the shoe.

  • Are there ways to strengthen and prepare feet and legs to dance en pointe?

                    Yes.  Because dancing en pointe requires increased muscle strength and balance, there are several activities and exercises that will prepare a dancer for these new stresses.

    1. Make sure you spend adequate time on ¾ pointe or demi pointe.  You should be very comfortable on ¾ pointe before you attempt to move into full pointe. Taping the toes can also help to protect them from the strain and rubbing of wearing pointe shoes.
    2. Participate in regular balance exercises with the goal of standing in passe en releve on each leg for 30 seconds without utilizing a bar.
    3. Stretch and warm up properly to ensure joints of the feet and legs are functioning properly.  A good pointing of the foot is imperative for the ability to move into full pointe dancing.
    4. Muscle strengthening is also an imperative.  Dancers are notoriously strong and can be seen as high level athletes, but the increased stress and strain of dancing en pointe requires even greater strength of the foot and ankles.

    There are some stretches and exercises that can help strengthen foot muscles and prepare ligaments and tendons to support the new weight distribution of dancing en pointe.


    Toe resistance band - Use an elastic band as resistance when doing range of motion or other exercises of the foot or ankle.  This is a great exercise to increase the strength of the foot and ankle.


    Find more exercises to strengthen the ankle here.

  • What should I watch for when my child begins dancing en pointe?

    • Injury to toenails or ingrown toenails

    • Blisters, new areas of pressure (redness) or callus locations

    • Pain in the ankle (including ankle injury)

    • Pain in the toes (toe injury)


    • Change of foot shape – bunions, hammertoes, over extension

  • What tests will determine pointe shoe readiness?

                    When you come in to Mountain West Foot & Ankle Institute to be evaluated to begin using pointe shoes, the doctor will perform several tests.  These tests are designed to evaluate bone development, growth plate maturity, balance, muscle strength and overall dancing health.  Through these simple tests, each dancer can be individually evaluated to determine if dancing en pointe is appropriate at their current age.  These tests will include:

    • X-ray exam of feet and lower legs.
    • Muscle strength testing.
    • Balance testing.
    • Careful evaluation of foot and ankle structurally.
    • It will often include recommendations on exercises or other activities to improve ability to dance en pointe without problems.

  • Should I Wait to Get into Pointe Shoes?


    As children learn and grow and their dance skills improve, getting into pointe shoes can be a very exciting moment.  

    However, it is important to make sure the child’s foot is properly developed before beginning pointe.           

    Although designed to facilitate dancing en pointe, pointe shoes distribute body weight very unnaturally over the foot, causing stress and strain in unusual areas.  In an immature foot or a foot without adequate strength to counteract the stress and strain, significant injury and even long-term problems can develop.  These problems could include stress fractures, tendon or ligament injury, severe ankle sprains, osteoarthritis, bunions and hammertoes.  Therefore, a dancer needs strong, developed feet in order to combat this stress and at least reduce the chance of injury or progressive deformity

    .  When you figure that deformities develop over time in the healthiest of pointe dancers, imagine how debilitating or limiting the injuries could be in a foot not prepared.



  • What is a Write Off?


                In the medical profession a write-off is a term used for when a doctor or facility forgives an amount that would otherwise be the patient’s responsibility.  There are federal laws and insurance contract provisions that specify what and when amounts may be written-off by a doctor or facility. If the charge is part of the patient's deductible, it is impossible to write off.

    Part of the "Understanding Insurance" series.  


  • What is a Managed Care Plan?

                The essence of managed care is lower medical cost in exchange for more limited choice.  The plan uses a small pool of contracted (or in-network) providers to lower cost.  Some of the money saved is passed onto the member’s premiums.


    Part of the "Understanding Insurance" series.  

  • Why Do I Get Shin Splints When Running?

    Many People Also Found These Articles Useful:

    What Is A Shin Splint?
    Do I Have Shin Splints?

    Shin splints are an overuse injury of the leg.  They are caused by the functioning of the foot during walking or running.  In fact, the condition is aggravated and often caused by pronation (flattening of the arch) or supination (increasing of the arch) throughout gait.  As the foot functions in this way, the muscles of the leg are aggravated and become increasingly painful and problematic. 

    Posterior or medial shin splints are commonly inflammation of the muscle attachment to the shin bone (tibia) and hurts as from pressure to the muscle just inside the bone.  Anterior or lateral shin splints are commonly inflammation to the tendon (posterior peroneal tendon) and adjacent tissues in the front of the outer lower leg.   In either case, the pain can present during a run, immediately following the run or sometimes the next day.


    What causes shin splints?

    The exact cause of shin splints are not known, but usually it is related to rapid increase in running, jumping, dancing or sprinting (or sometimes walking fast), changes in shoegear, or pronation (flattening of the foot).  Some secondary causes may be balance problems (leaning to one side during a run), poor training technique (progressing too fast, poor running technique or surfaces), leg length problems or even injury.


    Many People Also Found These Articles Useful:

    What Is A Shin Splint?
    Do I Have Shin Splints?

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