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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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  • Why Are High Arches Painful?

    Most people know that flat feet can be a problem, but are less aware of the less common condition of high arches.  It may be a good thing to have a well-developed arch, but an arch that is too high can cause pain and problems.

    When the arch is too high, it means there are structural abnormalities in the foot.  Bone positions may be off and bunions, hammer toes and corns are much more likely to occur.  One of the biggest problems with high arches is shock absorbtion.  The high arch poorly distributes the shock of the foot hitting the ground and causes increased stress to the ball of the foot and the heel.  This can lead to pain, bone and tendon injury.  This becomes even more of a problem when barefoot, in flip flops or other flat shoes.  Even common running shoes usually fail to provide necessary support to a high arch (they are usually designed for the average foot).  That's why specialized orthotics are so important for someone with high arches.  As you recieve better support, much of the pain to the arch will improve or even resolve.

  • 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.

  • Will I Lose My Toenail?

    Just because a toenail doesn't look normal, doesn't mean you will lose the nail.  There are many reasons the nails may not look normal including injury which can cause blackening of the nail, fungus toenails, ingrown toenails and even some diseases may cause different appearances to the nail.  Whatever the cause of the discoloration, the question is always whether you will lose the nail or not.

    Black Toe Nail:  Usually indicates trauma to the nail (dropping something on it, runner's toenail, or bumping it).  Depending on the extent of the injury, you may lose the toenail.  Often in this case, the nail will stay intact and be discolored for about 1 year (the amount of time to grow the nail out).

    Fungus Toenail:  Otherwise called onychomycosis.  Although this is a thickening and discoloration of the nail.  Unless the nail is pulled off by catching it on something, the nail is usually not lost.

    Ingrown Toenail:  Unless the nail is severely infected and fluid builds up under the nail, only the portion of the nail treated will be lost.  The nail usually is not.

    Other:  Most other discolorations of the nail will not usually cause the nail to be lost. 

  • Can I take anything to heal a fracture more quickly?

    Fractures are commonly encountered in our office, and never heal as quickly as you the patient would like. In fact, the pain will resolve before the fracture is fully healed.  With this in mind, however, there are several things that can affect the healing speed of any fracture.

    • Poor Healing Potential:  Poor nutrition, protein deficiency, smoking and even alcohol have been shown to interfere with healing of bone.  Smoking, for example, decreases blood flow to bone and will cause significant interference with bone healing (especially in feet and ankles).   Alcohol in excess has also been shown to be toxic to bone and may even lead to fractures.  Using care to limit these factors will increase your chances of healing.
    • Nutrition:  Fracture healing causes increased need for the intake of quality calories.  Increased caloric intake is often necessary to speed healing -- two to three times increase in calorie count may be required to match the energy needs of fracture healing (especially with multiple fractures).  The increased calorie count should be from healthy alternatives (not cookies, cakes, cheese burgers, etc.)
    • Protein Intake:  Protein is a key to bone healing, both because roughly half of bone volume is protein and many of the building blocks and enzymes the body utilizes in the healing process are formed from proteins.  Protein malnutrition or limitations may lead to a less rigid or "rubbery" callus.  Proper bone healing requires high protein levels to produce a rigid bony callus.
    • Increased Mineral Intake: Many individuals add calcium to their diet for bone healing, but this is insufficient to get necessary healing.  70% of bone weight is from minerals.  Fracture healing therefore requires the necessary minerals.

    Minerals

    Bone Healing Range/Day

    Healing Potential

    Calcium

    800-1200mg

    Main mineral of bone  (Dependant on vitamin D for absorption)
    Phosphorus

    800-1200mg

    Main mineral of bone
    Magnesium

    400-800mg

     
    Chromium

    200-1000mcg

     
    Silica (Silicon)

    5-20mg

    Important role in bone collagen formation.  Enhances effects of calcium and vitamin D on new bone formation
    Zinc

    12-30mg

    Aids in callus formation, enhances bone protein production, and facilitates bone healing.
    Manganese

    2-10mg

     
    Copper

    1-3mg

    Aids in formation of bone collagen.
    Boron

    3-5mg

     
    Potassium

    4000-6000mg

     
    • Increased Vitamin Intake: Vitamins play a key role in healing by stimulating the biochemical reactions that build the bone with the proteins and minerals.  In fracture healing, some principle vitamins are important.

    Vitamins

    Bone Healing Range/Day

    Healing Potential

    Vitamin D

    800-2000 IU

    Important regulator of calcium absorption.
    Vitamin C

    500-3000 mg

    Important antioxidant and anti-inflammatory nutrient.  Also essential in bone collagen formation.
    Vitamin K

    K1: 250-1000 mcg

    K2: 45-180 mcg

    Essential part of the biochemical process that binds calcium to bone.
    Vitamin B6

    25-50 mg

    Linked to bone healing
    Folic Acid/Folate

    400-1000 mcg

    Linked to collagen formation
    Vitamin B12

    150-1000 mcg

    Linked to bone healing
    • Other: There are also multiple herbal remedies/supplements  and alternative techniques that have been found to assist in bone healing.   

    Our recommendation (and what Dr Gibson did) is take a combination of vitamins, minerals and herbs along with a balanced, nutritious diet to speed bone healing.

  • Since I can walk on it, does that mean it isn't broken?

    Although a fracture will often limit the ability to walk on a foot or ankle, amount of fracture and levels of pain are individual.  In otherwords, some people handle pain easier than others.  With this understanding, there is a high risk of fracture if you are unable to walk on a foot, but even this is no guarantee.   Here are three keys to remember:

    1.  X-ray is the only way to confirm or refute a fracture.   If the x-ray is high quality (as in digital x-rays in our office for example), no fracture on x-ray is about 99% sure that even a stress fracture doesn't exist.

    2.  Stress fractures hurt, but can usually be walked on.

    3.  Severe sprains or strains may also limit your ability to walk, even in the absence of a fracture.

    If there is any concern that you may be fractured, (especially if pain is not improving) it is recommended you see a foot or ankle specialist ASAP.

  • Is foot pain a normal part of getting older?

    In the past, people thought pain was normal.  In fact, they figured aches and pains were part of getting "old".  The truth is far from this thinking:  Pain is NEVER normal.

    As you get older, you can develop conditions such as arthritis from wearing down of the joints.  You can get injuries that didn't occur at younger ages because of loss of the elasticity of the tissues (such as tendons or ligaments).  You can also get associated pain from change in metabolism that leads to increased weight on the feet.  Whatever the condition, age doesn't cause the pain but can influence its presentation. 

    That being said, in most cases things can be done to minimize the pain (or even resolve it) and allow you to continue to be active.  Don't let pain stop you.

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