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November 2021

Thermoregulation is the body’s process of maintaining its core internal temperature, which is typically between 98°F and 100°F. Sweating is one of the mechanisms the body uses to cool down because as sweat evaporates it cools the skin, which lowers our internal temperature. Excessive sweating in specific areas of the skin is known as hyperhidrosis, or sometimes is referred to as plantar hyperhidrosis when it occurs in the feet. The specific cause of Hyperhidrosis is unknown, however its possible triggers are believed to include emotions, hormones, physical activity, or brain signals which inaccurately prompt sweat glands to overreact even when it is not necessary for thermoregulation. Sweat that sits stagnant on the skin of the feet can compromise the top layer of skin, making it more susceptible to bacteria which can create odor and even expose the body to more serious bacteria. Podiatrists have a variety of treatment options to help control this embarrassing and uncomfortable condition.

If you are suffering from hyperhidrosis contact Dr. Robert Graser of Graser Podiatry and Bunion Surgery Institute. Our doctor can provide the care you need to attend to all of your foot and ankle needs.

Hyperhidrosis of the Feet

Hyperhidrosis is a rare disorder that can cause people to have excessive sweating of their feet. This can usually occur all on its own without rigorous activity involved. People who suffer from hyperhidrosis may also experience sweaty palms.

Although it is said that sweating is a healthy process meant to cool down the body temperature and to maintain a proper internal temperature, hyperhidrosis may prove to be a huge hindrance on a person’s everyday life.

Plantar hyperhidrosis is considered to be the main form of hyperhidrosis. Secondary hyperhidrosis can refer to sweating that occurs in areas other than the feet or hands and armpits. Often this may be a sign of it being related to another medical condition such as menopause, hyperthyroidism and even Parkinson’s disease.

In order to alleviate this condition, it is important to see your doctor so that they may prescribe the necessary medications so that you can begin to live a normal life again. If this is left untreated, it is said that it will persist throughout an individual’s life.

A last resort approach would be surgery, but it is best to speak with your doctor to find out what may be the best treatment for you.

If you have any questions please feel free to contact our office located in Boerne, . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

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Published in Blog
Tuesday, 30 November 2021 00:00

Hyperhidrosis of the Feet

Each foot, on average, has about 250,000 eccrine sweat glands that produce half a pint of sweat each day. Sweating is a natural and important bodily function. It regulates the body’s temperature by cooling the skin so that it does not overheat.  In individuals with hyperhidrosis, the sympathetic nervous system works in "overdrive", producing far more sweat than what is required. People with plantar hyperhidrosis experience an excess amount of sweat on their feet. It is estimated that 2% to 3% of all Americans suffer from some form of hyperhidrosis. This condition is often caused by neurologic, endocrine, infectious, and other systemic disease. Other factors that may trigger the condition are heat and emotions.

People with hyperhidrosis may notice an overabundance of sweat on their feet, along with a strong odor. The feet may also have a wet appearance coupled with infections such as athlete’s foot or toenail fungus. The sweat may even appear in low temperatures, such as during the winter months. People with plantar hyperhidrosis often need to change their socks several times throughout the day.

The specific cause of hyperhidrosis is unknown, and many believe it may be caused by over-activity. However, others believe the condition is genetic.  Caffeine and nicotine are known to cause excitement and nervousness which are two emotions that may make the condition worse.

If you are looking to treat your hyperhidrosis the most important thing you should do is wash your feet every day.  You may even need to wash your feet twice a day, if necessary.  You should also make sure you are wearing the right socks. Wool and cotton socks are both known to be good for ventilation, meaning they allow the feet to breathe. You should avoid socks made from nylon which trap moisture and lead to sogginess. Other common treatment options are over-the-counter antiperspirants that contain a low dose of metal salt.  In some cases, prescription strength antiperspirants that contain aluminum chloride hexahydrate may be necessary. In severe cases, surgery may be required.

Untreated hyperhidrosis can easily lead to complications.  Some complications that may arise from the disorder include nail infections, warts, and bacterial infections.  Consequently, it is important that you seek treatment from your podiatrist if you suspect that you may have plantar hyperhidrosis.

Published in Featured
Tuesday, 23 November 2021 00:00

Understanding Achilles Tendon Injuries

On the back of the ankle, there is a thick band of tissue that connects the calf to the heel bone. This is known as the Achilles tendon. If this tendon becomes inflamed near the heel bone, usually due to overuse, it is known as Achilles tendonitis. Patients who have Achilles tendonitis often experience stiffness in the Achilles area, pain in the back of the heel, and swelling. If left untreated, Achilles tendonitis can cause the tendon to degenerate resulting in Achilles tendinosis. If the fibers in the tendon tear (either partially or completely), it is known as an Achilles tendon rupture, which is one of the most severe injuries that can occur to that area. Patients who have pain or stiffness around their Achilles tendon should have it looked at by a podiatrist who can properly diagnose and treat their condition.        

Achilles tendon injuries need immediate attention to avoid future complications. If you have any concerns, contact Dr. Robert Graser of Graser Podiatry and Bunion Surgery Institute. Our doctor can provide the care you need to keep you pain-free and on your feet.

What Is the Achilles Tendon?

The Achilles tendon is a tendon that connects the lower leg muscles and calf to the heel of the foot. It is the strongest tendon in the human body and is essential for making movement possible. Because this tendon is such an integral part of the body, any injuries to it can create immense difficulties and should immediately be presented to a doctor.

What Are the Symptoms of an Achilles Tendon Injury?

There are various types of injuries that can affect the Achilles tendon. The two most common injuries are Achilles tendinitis and ruptures of the tendon.

Achilles Tendinitis Symptoms

  • Inflammation
  • Dull to severe pain
  • Increased blood flow to the tendon
  • Thickening of the tendon

Rupture Symptoms

  • Extreme pain and swelling in the foot
  • Total immobility

Treatment and Prevention

Achilles tendon injuries are diagnosed by a thorough physical evaluation, which can include an MRI. Treatment involves rest, physical therapy, and in some cases, surgery. However, various preventative measures can be taken to avoid these injuries, such as:

  • Thorough stretching of the tendon before and after exercise
  • Strengthening exercises like calf raises, squats, leg curls, leg extensions, leg raises, lunges, and leg presses

If you have any questions please feel free to contact our office located in Boerne, . We offer the newest diagnostic tools and technology to treat your foot and ankle needs.

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Published in Blog
Tuesday, 23 November 2021 00:00

Achilles Tendon Injuries

The Achilles tendon is the largest tendon in the body; it is a tough band of fibrous tissue that stretches from the bones of the heel to the calf muscles. This tendon is what allows us to stand on our toes while running, walking, or jumping, it is common for this tendon to become injured. In severe cases, the Achilles tendon may become partially torn or completely ruptured. However, this tendon is susceptible to injury because of its limited blood supply and the high level of tension it endures.

The people who are more likely to suffer from Achilles tendon injuries are athletes who partake in activities that require them to speed up, slow down, or pivot. Consequently, athletes who engage in running, gymnastics, dance, football, baseball, basketball, or tennis are more likely to suffer from Achilles tendon injuries. Additionally, there are other factors that may make you more prone to this injury. People who wear high heels, have flat feet, tight leg muscles or tendons, or take medicines called glucocorticoids are more likely to have Achilles tendon injuries.

A common symptom of an Achilles tendon injury is pain above the heel that is felt when you stand on your toes. However, if the tendon is ruptured, the pain will be severe, and the area may become swollen and stiff. Other symptoms may be reduced strength in the lower ankle or leg area, and reduced range of motion in the ankle. When the Achilles tendon tears, there is usually a popping sound that occurs along with it. People who have acute tears or ruptures may find walking and standing to be difficult.

If you suspect you have injured your Achilles tendon, you should see your podiatrist to have a physical examination. Your podiatrist will likely conduct a series of tests to diagnose your injury including a “calf-squeeze” test. Calf squeeze tests are performed by first squeezing the calf muscle on the healthy leg. This will pull on the tendon and consequently cause the foot to move. Afterward, the same test will be performed on the injured leg. If the tendon is torn, the foot won’t move because the calf muscle won’t be connected to the foot.

Published in Featured
Thursday, 18 November 2021 00:00

Are You Suffering From Ingrown Toenails?

If left untreated, an ingrown toenail can lead to more serious concerns, such as an infection. Knowing proper nail care can help in the prevention of an ingrown toenail. Give us a call, and get treated!

Published in Blog
Tuesday, 16 November 2021 00:00

What Podiatrist Do to Help Treat Flat Feet

Some babies are born with flat feet and as they grow, the tendons in their feet tighten and formulate arches, typically by the time they reach 2 or 3 years of age. If arches never develop in babies feet, or they present only when they are sitting or on their toes, this is known as rigid flatfoot or flexible flatfoot, respectively. Flatfoot may be asymptomatic, or produce symptoms such as pain on the outside of the ankle, or achy, tired feet after playing sports or standing for extended periods of time. Calf muscles may also be tight, and there can be problems walking, standing, or balancing. If you are experiencing symptoms like these, contact a podiatrist to be diagnosed and treated properly. To determine if your condition is rigid or flexible, the podiatrist may ask you to stand on your toes. If your arch becomes visible while standing on your toes and collapses when you place your foot on the floor, you may be afflicted with flexible flatfoot. If your arch never presents (even while on your toes), the podiatrist may order a CT scan, MRI, or X-ray to make a diagnosis of rigid flatfoot. Your podiatrist may prescribe custom orthotics or special shoes to provide arch support and relieve pain, and/or calf muscle stretches to help improve ankle range of motion (dorsiflexion). If these more conservative techniques do not offer relief, surgery may be necessary to relieve pain, repair tendons, and restore the arch.

Flatfoot is a condition many people suffer from. If you have flat feet, contact Dr. Robert Graser from Graser Podiatry and Bunion Surgery Institute. Our doctor will treat your foot and ankle needs.

What Are Flat Feet?

Flatfoot is a condition in which the arch of the foot is depressed and the sole of the foot is almost completely in contact with the ground. About 20-30% of the population generally has flat feet because their arches never formed during growth.

Conditions & Problems:

Having flat feet makes it difficult to run or walk because of the stress placed on the ankles.

Alignment – The general alignment of your legs can be disrupted, because the ankles move inward which can cause major discomfort.

Knees – If you have complications with your knees, flat feet can be a contributor to arthritis in that area.  

Symptoms

  • Pain around the heel or arch area
  • Trouble standing on the tip toe
  • Swelling around the inside of the ankle
  • Flat look to one or both feet
  • Having your shoes feel uneven when worn

Treatment

If you are experiencing pain and stress on the foot you may weaken the posterior tibial tendon, which runs around the inside of the ankle. 

If you have any questions please feel free to contact our office located in Boerne, . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

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Published in Blog
Tuesday, 16 November 2021 00:00

Flat Feet

Flatfoot is a condition that occurs when the arches on the foot are flattened, which allows the soles of the feet to touch the floor. Flatfoot is a common condition and it is usually painless.

Throughout childhood, most people begin to develop arches in their feet, however, some do not. Those who do not develop arches are left with flatfoot. The pain associated with flat feet is usually at its worse when engaging in activity. Another symptom that may occur with those who have this condition is swelling along the inside of the ankle.

It is also possible to have flexible flatfoot. Flexible flatfoot occurs when the arch is visible while sitting or standing on the tiptoes, but it disappears when standing. People who have flexible flatfoot are often children and most outgrow it without any problems.

There are some risk factors that may make you more likely to develop flatfoot. Those who have diabetes and rheumatoid arthritis have an increased risk of flatfoot development. Other factors include aging and obesity.

Diagnosis for flat feet is usually done by a series of tests by your podiatrist. Your podiatrist will typically try an x-ray, CT scan, ultrasound, or MRI on the feet. Treatment is usually not necessary for flat foot unless it causes pain. However, therapy is often used for those who experience pain in their flat feet. Some other suggested treatment options are arch supports, stretching exercises, and supportive shoes. 

Published in Featured
Tuesday, 09 November 2021 00:00

Thin Cracks in Foot Bones

Stress fractures are very thin cracks in a bone. They are often called hairline fractures because of their thin, hair-like appearance. These fractures are typically caused by overuse. Symptoms may include pain which develops gradually in a generalized area, swelling, tenderness, and difficulty bearing weight on the affected foot. A podiatrist can diagnose a stress fracture through a physical examination and X-ray, MRI, or bone scan. Stress fractures are particularly common among runners, basketball players, and ballet dancers. A stress fracture in the foot can affect any of the foot bones, but is usually found on the metatarsal, navicular, calcaneal, medial malleolus, or talus bones. If you suspect that you may have a stress fracture, please seek the care of a podiatrist.

Activities where too much pressure is put on the feet can cause stress fractures. To learn more, contact Dr. Robert Graser from Graser Podiatry and Bunion Surgery Institute. Our doctor can provide the care you need to keep your pain free and on your feet.

Dealing with Stress Fractures of the Foot and Ankle

Stress fractures occur in the foot and ankle when muscles in these areas weaken from too much or too little use.  The feet and ankles then lose support when walking or running from the impact of the ground. Since there is no protection, the bones receive the full impact of each step. Stress on the feet can cause cracks to form in the bones, thus creating stress fractures.

What Are Stress Fractures?

Stress fractures occur frequently in individuals whose daily activities cause great impact on the feet and ankles. Stress factors are most common among:

  • Runners                                  
  • People affected with Osteoporosis
  • Tennis or basketball players
  • Gymnasts
  • High impact workouts

Symptoms

Pain from the fractures occur in the area of the fractures and can be constant or intermittent. It will often cause sharp or dull pain with swelling and tenderness. Engaging in any kind of activity which involves high impact will aggravate pain.

If you have any questions please feel free to contact our office located in Boerne, . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Dealing with Stress Fractures of the Foot and Ankle
Published in Blog

Stress fractures are small breaks in the bone that are caused by repetitive stress. They typically occur due to overuse, forcing the bones of the foot or ankle to continually absorb the full impact of each step taken. Stress fractures can also be caused by abnormal foot structure, osteoporosis, bone deformities, or wearing improper footwear during exercise.

Stress fractures are common for individuals whose daily activities cause high levels of impact on their feet and ankles. Those who run, play tennis or basketball, or practice gymnastics tend to experience these fractures more frequently. Anyone is susceptible to this problem, though. Individuals who are normally sedentary and suddenly begin an intense, high impact workout may sustain stress fractures. This is because their muscles are not yet strong enough to handle and cushion the intensity of their activity. Osteoporosis may also cause someone to get stress fractures, because the disease weakens an afflicted person's bones and makes it easier for them to break down.

Pain from stress fractures typically occurs in the general area of the fracture. Pain can also manifest as “pinpoint pain” or pain that is felt when the site of the injury is touched, and can be accompanied by swelling. It may occur during or after activity, and it may disappear while resting and return when standing or moving. Engaging in any kind of activity, high impact or otherwise, will aggravate the pain. If the intensity of the activity increases before the stress fracture has properly healed, it can cause a full fracture.

Treatment can vary depending on the individual and the degree of injury. The primary way to treat a stress fracture is to rest the hurt foot. Some fractures will heal quickly with only a little bit of rest, while others may require a long rest period and the use of crutches, immobilization, or physical therapy. Under certain circumstances, surgery may be required to install support pins around the fracture to assist in healing.

If you are undergoing a new exercise regimen in running or some other kind of high impact activity, set incremental goals on a weekly basis so you can build up muscle strength. Make sure to wear supportive shoes to better protect you feet.

If you begin to experience any symptoms of stress fractures, you should stop exercising and rest. If the symptoms persist, consult with your podiatrist. Remembering these tips can help you prevent stress fractures to your foot and ankle, and allow you to continue living normally.

Published in Featured
Tuesday, 02 November 2021 00:00

Ankle Pain

The ankle joint is the point at which the bones of the leg and foot join. This joint is crucial because it is responsible for the foot’s mobility. Ankle pain is typically the result of inflammation from an injury to bones, joint space, cartilage, ligaments, tendons, or muscles in the area. Commonly associated symptoms with ankle pain are bruising, redness, numbness, stiffness, weakness, and tingling.

The most common causes of ankle pain are sprains and injuries. Ankle sprains are one of the most common musculoskeletal injuries. Sprains occur when the ligaments of the ankle become partially or completely torn due to sudden stretching. Sprains can occur on either the inner or outer sides of the ankle joint. Usually, these injuries occur when the ankle is twisted in an activity by stepping off an uneven surface. More specific causes include rheumatoid arthritis, gout, osteoarthritis, and Achilles tendonitis.

If you are experiencing ankle pain, you should consult with your podiatrist to choose the best method of care. Your doctor will conduct an examination of your ankle to determine the underlying cause of the pain.

Published in Featured
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