Do you have one leg that is shorter than the other?

Many people have one leg that is shorter than another. This is referred to as a limb length discrepancy. Although many people may be worried about this, the majority of the population has some amount of difference between the two. So, most people will go through their lives never realizing that there is any difference. For some people though, limb length differences can be significant enough that it can affect the way that they walk.

When the difference affects the way that you walk, you may need to exert a greater amount of energy to be able to walk down the street. It also may cause your hips to bend one way or another. This bending can cause an individual to visually tilt from one side another while they are walking. Dependent upon the severity of the discrepancy, they may have pain in their back or their legs.

So, what do you do about a short leg? Well, we could try lying you down on a table and stretching the one leg until it is the length of the other, but this is considered barbaric and is very inefficient. So, instead, we use devices that are known as heel lifts. These can be used either inside of your shoe, on an orthoses inside your shoe or on the outside of your shoe. This will function to lift your foot to where it will function at the same level as your other. This will work to prevent your pain and allow you to function normally.

If you or someone that you know has a limb length discrepancy and you live in the Methuen, Lowell, North Andover, Tewksbury, Massachusetts area, our office staff would be more than happy to help you schedule an appointment. Through a few quick measurements, Dr. Wachtel will be able to determine if a limb length discrepancy is causing your pain, or if your symptoms are due to something else.

2012 Olympic Athletes: Sports Medicine

In honor of the opening ceremonies of the Olympics tonight, let’s talk about sports medicine. Athletes are a special breed of human beings that push themselves to be better every step of the way. Due to this drive that they possess, they often push themselves through injuries refusing to take proper care of themselves and wanting to get back to the grind of things as quickly as possible. This means that these patients are very unlikely to be willing to take 6-10 weeks of being off of their feet.

Athletes require the best care that can be provided to get them back to the level of athleticism they were at or even better, but they also need to have a quick return. Luckily for these patients, the shape that they are in already gives them a heads up over the average patient because their bodies are in awesome condition. These patients often immediately go for an x-ray, CT, MRI, ultrasound, the whole work-up. This allows them to know exactly what is going on with their body because they pride themselves on knowing their bodies head to toe.

Athletes are also patients that pay very close to their nutrition. Because of this, they may be difficult to convince that their diet needs to be changed to allow for optimal healing. However, adjusting their diet will encourage healing and will speed the process along.

Athletes will also require constant follow-up on their healing. This means that they will require a lot of communication with their doctor to ensure that they are healing in the way they want to and getting the best care that they can receive. Due to this, the patient physician relationship is very strong and relies strongly on a sense of trust.

There are three key things that we could all stand to learn from athletes.

1.       It is important to know your body so that when something is wrong we know right away.

2.       It is key to have a good patient physician relationship so that you can trust their advice.

3.       Being in the best physical shape that you can will allow you to heal the best that you can.

Enjoy the Olympics games through the next couple of weeks and remember that as soon as you start to experience foot pain, our office would be more than happy to help you schedule an appointment. Our offices serve Methuen, Lowell, North Andover and Tewksbury, Massachusetts.

Olympic Gymnastics Team's Podiatric Problems

The men and women’s US gymnastics teams are suffering from foot injuries. Both McKayla Maroney and Sam Mikulak are struggling with sore feet as they get ready to go into the Olympics in the upcoming week. McKayla Maroney is struggling with a sore right foot and Sam Mikulak sprained his left ankle during a vault on the first day of the Olympic trials.

Foot injuries are easy to come by in gymnastics due to all of the high impact landing that the gymnasts do throughout their routines. The force of their entire body is increased several times when they land on their feet due to the momentum that they have gained leading up to their handsprings and dismounts. The impact can lead to fractured bones, twisted ankles and a wide array of other complications. These injuries can make it very painful to impossible to compete.

The Olympics is an impressive event that show cases the best athletic talent there is throughout the world. Many times we can recall an injury that completely changed an athlete’s Olympic outlook. The injuries that these athletes get can be very similar to the ones that we get in our daily routine. A wrong step can result in a sprained ankle, just as easily as a long day on flat feet can lead to a great amount of pain and discomfort.

Many times the injuries or the pain that we suffer on a day to day basis is due to our foot type. There exists this theoretical perfect foot type that very few people actually possess and then there is the rest of us. Most of us have some degree of flattening of our foot or increased arch of our foot or some other foot abnormality that causes us to be prone to certain injuries. Now, for many of us, this may not bother us until we start to age, but when are feet begin to hurt, the excuse of I’m just old is not a very good one to live by.

Orthoses are inserts that fit into your shoe and they function to help to position your foot into the ideal position that allows for the best positioning of your foot for walking. By putting your foot into this position, you are decreasing the amount of other work your foot has to do to be able to walk. As a result, you will decrease or even eliminate the pain your foot is feeling.

If you or someone you know lives in the Methuen, North Andover, Tewksbury or Boston, Massachusetts area our office staff would be more than happy to help you schedule an appointment. Dr. Wachtel will be able to examine your foot and determine the best treatment for your individual foot type.

David Ortiz's Ankle Injury

First baseman and designated hitter, David Ortiz, of the Boston Red Sox, injured his ankle rounding 2^nd base on Monday night. The Red Sox powerhouse says that he did not hear any kind of pop but said that he was limping pretty badly to get back into the dugout. The manager of the Red Sox claims that he is not concerned about Ortiz being gone for long and is convinced that at most he will miss a few games. However, Ortiz was schedule to get an MRI this past Tuesday to figure out what exactly is going on.

Ankle injuries can be very tricky because there are a lot of structures that can be injured in a small area. You have ligaments that traverse either side of your ankle and behind and in front of it. You also have 3 key bones, the talus, the tibia and the fibula, in that area that can be injured. In addition you have 7 tendons in the vicinity that can all be injured. In addition there are the nerves and vascular structures. To sum it all up, you have a lot of anatomy in a small area that all has the potential to be injured depending on the severity of your accident.

Many people will talk about the “pop” that you don’t want to hear when you injure a joint. However, this pop is not the only telltale sign of an injury.  The first thing that many people will see is a lot of swelling in the affected area. This swelling is typically a good indicator that an injury of some sort has occurred. Ortiz’s doctors are right though that you need to be able to visualize the area to determine what is going on. This is why we use imaging modalities such as x-ray and MRI to be able to ascertain the extent of your injury.

It is important to seek medical assistance from your podiatrist after an injury, because everyone reacts to pain differently. So what may be a level 3 for one person could be 10/10 for another for the same amount of trauma. By looking at the area, your physician will be able to determine what amount of treatment is required. This can range from rest, relaxation, some pain relief and staying off of your foot, clear to extensive surgery. Whichever one it ends up being, your doctor will be able to give you the care and instruction you need to prevent further injury.

If you have suffered from an ankle injury and live in the Methuen, North Andover, Lowell or Boston, Massachusetts area, our office staff would be more than happy to help you schedule an appointment. Through the proper tests and a through exam, Dr. Wachtel will be able to determine what you need to get you back into tip top shape.

Are Flip Flops Good For Your Feet, or Just a Flop?

CBS News ran an article today in the Health Pop section of their website. The article addressed the fact that flip flops, as great as they might be for summer weather, can cause a lot of foot issues for certain foot types. These problems will particularly affect people that have high or low arches. In the article this foot type is referred to as one that is not balanced.

The majority of flip flops that are sold today offer no arch support at all. As a result, if you use flip flops when you are doing anything more than leisurely hanging out with friends, you can end up doing more harm to your foot that you imagine. Most shoes have a good arch support that stabilizes your foot while you are jumping, running, walking, or any other movement you can think of. As we get older, our feet tend to flatten out naturally as a result of aging, less ability to heal or due to becoming overweight. When your body becomes heavier, your foot will flatten out as a result of a greater amount of force on them. There are some sandals that actually do offer a greater amount of support. These sandals are ones that naturally have an arch support built into them.

For patients that have a flat foot type it is best for them to wear a sneaker that will provide them with an arch support. Depending upon how flat your foot is, you may need a greater amount of support that come in the form of an orthoses. Orthoses are inserts that are put in your shoe and can be used to move your foot into a better position allowing your foot to move through the motions needed for walking. By correcting the foot position, it will help to prevent the pain that you are experiencing while walking.

If you or someone that you know struggles with flat feet and is experiencing pain as a result, our office staff would be more than happy to help you set up an appointment. Through casting your foot and performing a biomechanical exam, Dr. Wachtel will be able to help you find the proper type of orthoses to help your foot type. Our offices serve people that live in the Bradford, Methuen, Lowell and North Andover, Massachusetts area.

Elective Podiatric Surgery

ABC News recently ran a feature story talking about plastic surgery for feet. Plastic surgery is defined as any surgery that is unnecessary for the person’s health. These surgeries are instead performed solely to affect the appearance of a certain part of the body. In podiatry there are several cosmetic surgeries that are regularly performed. These are surgeries for bunions, hammer toes and claw toes. Podiatrists perform these types of surgeries on a daily basis throughout the country. The majority of these cases are done when the patient is having pain associated with their deformity. Over the past several years though, more and more of these surgeries are being done for appearance. Recently, procedures to shorten the length of your toes have become increasingly popular as well.

Recently there has been a fashion shift in shoe wear leading to more sandals, flip flops, and open toe shoes. With this trend, women especially, have become more conscientious about the appearance of their feet. They have a tendency to look at their feet and see these deformities that have been gradually getting worse throughout their lifetime, and they don’t like what they see. When this happens, they are prone to ask the question, “Can this be fixed?”  The truth of the matter is that yes these can be fixed and they are on a daily basis for those painful ones that have failed conservative therapy. The reality is that the decision to do cosmetic foot surgery is really a personal decision of the physician. Many physicians operate by the rule of thumb that if it is not causing you any kind of problem, then why would they cut you open and risk infection and a problem coming from something that was healthy. Other physicians think of it as preventative medicine because they believe that the deformity will only get worse and they are fixing it before it becomes a problem. Which thinking is right? Well there really isn’t a good answer for that because both of these scenarios have pros and cons. However, if the trend of open toed footwear continues, chances are that you will see much more of this surgery in the next several years.

If you or someone that you know is experiencing any type of foot related problems, our office staff would be more than happy to make an appointment for you. Our offices serve Tewksbury, Methuen, North Andover and Lowell, Massachusetts and the surrounding areas.

What Could be Causing the Swelling on the Top of my Foot?

With as gorgeous as it has been lately, many people are out playing soccer and football in the yard. Since these are contact sports that can often lead to someone getting tripped or tackled, it is pretty common for people to trip with their foot pointing down towards the ground. When this occurs, you can injure a ligament, the Lis Franc injury, that connects your midfoot to the forefoot. This ligament when injured will make the midfoot unstable and can lead to fracture and/or dislocation.

If an injury like this happens, there will be marked swelling of the top of your foot. There will also be a great deal of pain in your foot. Lis Franc injuries are difficult to assess without radiographical visualization of your foot because these injuries have a good deal of variation. The injuries can have dislocations, ligament injuries and fractures, or any combination of the above. Through x-ray visualization, your physician will be able to determine what has been injured and how severe the injury is.

Since there is such a large amount of variation in these injuries, there is also a wide range of treatment plans that exist. If the injury is solely ligamentous and a complete tear has not occurred, treatment will consist of a non-weight bearing cast that will immobilize your foot and allow it to heal. However, if the injury is anything other than just a partial tear of the ligament, then you will require surgery.

When you have swelling on the top of your foot, it is very important that you seek the help of your podiatrist. Through a physical exam and the appropriate imaging studies, they will be able to determine the type of treatment that you need to heal your injury. If you live in the Methuen, North Andover, Tewksbury or Boston, Massachusetts area, Dr. Wachtel can see you and determine the cause of your symptoms. Our office staff would be more than happy to help schedule you an appointment. In no time, you will be back up and on your feet again.

The Bugs of Summer

A heat wave has hit the United States, and with this unbelievable heat comes a need to stay cool in any way that we can. This means shorts and short sleeve tops, flip flops and swimsuits and the beach, pool, or whatever you have available. It also means that you are going to be tempted to go around barefoot outside to try and keep cool. Although this may make the heat a little more bearable, it also opens you to infection from organisms that live in the soil.

There are three main parasitic worms that can enter your feet from the soil. These include Strongyloides Stercoralis, Ancylostoma Duodenale and Trichinella Spiralis. These worms are primarily in the southern states of the US. Once these worms get into your system they will cause you to have severe intestinal infection that will cause nausea, stomach pain or diarrhea. Luckily, these little worms can be treated with a prescription that will kill them off and cure your symptoms.

It is easy to forget your feet because many of us take them for granted. However, your feet serve as a sort of portal into the rest of your system. They come into contact with every surface that you walk on, and with that everything that lives in the area you are walking in.

So, regardless of how hot it is outside, it is important to remember to wear some sort of shoe wear to protect your feet when you are walking around outside, whether it is in the dirt or a stream. This will serve to protect you from the organisms in the area and sharp objects that can injure you.

If you or someone you know notices a red swollen area on your foot after walking around barefoot outside, it is important to seek the care of your local podiatrist. There are many organisms that can cause you much greater trouble the longer that they go untreated. If you live in the Methuen, Tewksbury, North Andover or Lowell, Massachusetts area, Dr. Wachtel would be more than happy to help you determine what is causing the inflammation and swelling in your feet.

Olympic Hopeful's Achille's Heel

Achilles injuries are typically touted as being due to obesity and a sedentary lifestyle. Gradually overtime the tendon becomes weakened which leaves it more prone to injury, especially with a bad step or a new workout plan. Achilles injuries can also be due to being worked hard, such as in a runner. A recent example in the news of this incidence is Olympic hopeful Jenny Meadows from London. She is set to compete in the trials for qualifications, but her recent reinjury to her Achilles tendon may make it better for her this year.

There are many different levels of injury to the Achilles tendon dependent upon how severe the actual injury is. Two imaging modalities that are great for visualizing the tendon are Ultrasound and MRI. On an MRI, you are able to determine if the injury is taking up part of the tendon or the entire thing. Injuries are classified as being minor or major partial tears or a complete rupture. The level of your injury will determine the course of action that is best for your treatment.

For smaller injuries, a great modality is laser treatment of the injured area. Laser treatment consists of treating the area with a specific wavelength of energy that will stimulate the area to become an acute injury again allowing all of the cells necessary for proper healing to migrate to the area once again. By giving your body the chance to heal this area as an acute injury, it means that you are much more likely to see the strength and quality of your once injured tissue return to that of its pre-injury quality.

If the injury is more severe, immobilization to provide the injury with time to heal followed by physical therapy to regain strength may be the best option. Finally, if the tendon has actually ruptured then surgical treatment is the recommended course to reattach the tendon to its proper location.

An Achilles injury can range from a pain level of barely any clear up to excruciating pain at your heel. This is why if you notice any swelling in the area or bruising, it is very important to seek consult from your podiatrist. If you or someone you know has suffered from any level of Achilles injury, our office staff would be more than happy to schedule an appointment for you. Our offices serve the Methuen, Lowell, Burlington and Stoneham, Massachusetts.