Dr. Oz Talks Feet

On January 25, 2011 Dr. Oz did a piece on nail fungus. This is probably because nail fungus is becoming a very common problem.  Nail fungus occurs in the toenails of the foot.  Nail fungus in toenails can be identified in many ways. The toenail may be thick and turn white, yellow, and brown. Fungal infections in the nail are called onychomycosis.  Many patients develop nail fungus in the nail, and if not treated effectively all of the nails can become infected.

The problem with nail fungus, or onychomycosis, is that if it does go untreated the thickness of the nail can cause ingrown nails or an infection of the nail.  Many times patients who are diabetic and have onychomycosis can have complications, such as infection, just from the thickness of a toenail. Patients that have diabetes or other patients that may be compromised, sometimes have a hard time healing from infections caused by the nail.  This is why it is so important to treat toenail fungus to prevent further progression.


There are multiple causes for nail fungus or onychomycosis.  The most common reason for nail fungus is trauma.  Trauma occurs either by the actual bumping of the nail against a surface, like stubbing your toe, or more commonly tight shoe gear. Fungus grows from inside the shoe and cross infects the skin. It can be an ugly cycle of shoe to skin and skin to shoe fungal infections.  Lastly instruments that are not properly sanitized may play a role.

Dr. Oz mentioned treatment with vinegar for onychomycosis, which we feel is a myth. Oral medications for nail fungus are quite toxic for the liver and should be prescribed with caution.  Some of the newer, more effective treatments include mechanically cutting the nail and thinning it out. This should be performed professionally by a podiatrist.  There are very effective topical treatments for onychomycosis.  A new topical medication called Formula3 is a very effective way of treating nail fungus. This medicine penetrates through the nail to the nail bed to kill the fungus.  The new technique for eradicating onychomycosis is laser treatments, which are effective and safe.  Podiatrists are now providing laser treatments from their offices.  You can see the results anywhere between six to twelve months from the end of the treatment.  One other problem we see in most patients is improper shoe gear. This occurs because we walk with the toes extending upwards, which hit the top of the shoe. It would be wise to have a foot doctor evaluate the shoe gear and prescribe a shoe that has enough width for the sides of the toes and enough depth for where the toes extend (extra depth shoes are useful).  Lastly treating the shoe is just as important as treating the nail infection to prevent recurrence of the nail infection.   There are devices that can irradiate the shoe to prevent fungal infection.  Moisture control of the skin of the foot should be evaluated as well.  The best clinician to evaluate these problems would be a podiatrist.

Does Anyone Really Know What Podiatry Actually Is?

Years ago a chiropodist would only treat the foot, corns, and calluses. Today, a podiatrist, or a foot specialist, treat a wide array of foot and ankle problems. Commonly seen in a foot doctor’s office are ingrown toenails, heel and ankle pain, ankle sprains, fractures, and wounds. Surgery of the foot and/or ankle is also provided by a foot doctor. Surgically we treat an assortment of foot ailments, including bunions, ingrown nails, fungal nails, heel surgery, impinged nerve surgery, which is also known as a neuroma, hammertoe surgery, and bone spur removal. We can treat a variety of fractures in the foot with either below knee casting, surgical shoes, or below the knee walkers. There are times when fractures of the foot need fixation through means of screws or pins. Other forms of treatments are prescribing medication, whether it’s antibiotics, antifungal medications, and medications after surgery. Podiatry is not just about cutting toenails, there are so many other problems that we can  treat to get you back on your feet in no time at all.

I'm Told Stretching is Important. But Why?

         Does stretching help older people become better runners? Absolutely! It is incredibly important to stretch before running for many different reasons. Most runners are able to run for longer distances if they have done a good stretch before. You always hear about how you should stretch before a good workout, but do you know why? Proper stretching preceding a workout will decrease lactic acid buildup. Cramps and leg or foot pain are caused by a decrease in oxygen to the muscles, which then causes a lactic acid build up. When lactic acid builds up it causes a cramp.  So if you stretch before you run, pain in yourmuscles legs and feet will be decreased.

Do runners lose flexibility as they age? Not necessarily. The more you exercise the more flexible your muscles are. The more flexible your muscles are the longer you can run. Stretching routinely will provide you the ability to continue running with minimal cramping and discomfort. Normal aging probably won’t decrease flexibility. However, if a person decreases their exercise regiment their ability to run will decrease from loss of muscle tone.

          Routine stretching before and after running are important for the ability to run. As we age muscle atrophy, or muscle break down, occurs if we stop using certain muscles. Stretching exercises to prevent muscle breakdown is very important.

          Flexibility and ability to run is not truly age dependent, but dependent on several factors: muscle tone, muscle use, and proper stretching both before and after exercise. If possible never lead a sedentary life and always develop a plan to stretch and strengthen your muscles.