December 2017

Your body goes through a lot of changes during pregnancy – the belly becomes bigger and rounder, hormones change and fluctuate, bones shift, and some parts of your body swells. In particular, your feet can undergo much more stress than they normally do in order to keep you active and stable.

Some foot problems pregnant women may encounter include:

• Pain along the plantar fascia (ligament on the bottom of your feet) – As you carry more weight, the feet have to work harder and undergo much more pressure than they are used to. Excess weight can even change your feet to be flat feet.
• Swelling – Blood and fluid alone can be the cause of up to 20 pounds of weight gain during pregnancy. Long periods of standing, sitting, or work (including walking) can prevent circulation and cause swelling.
• Instability – With swelling and extra pressure on the feet, it’s possible that your feet can be less alert and sensitive. This can cause instability, especially if you are in high heels.

To combat these problems, here are some tips for keeping your feet happy:

• Be active – Long periods of inactivity (or too much activity) can cause pain and swelling for your feet. If you have an office job, try to get up, stand, and move your feet as much as possible to increase circulation.
• Hydrate – This will also help you with circulation, as well as give you an excuse to move with trips to the restroom!
• Wear compression socks – this will help prevent swelling in the feet and ankles.
• Relax in a warm Epsom salt, cold Tonic water, or warm Grapefruit Essential Oil foot soak – This is a great way to give your feet some pain relief, as well as reduce swelling.
• Get a foot rub – If possible, get regular foot massages to pamper your tired, hard-working feet. At home, have your partner give you a foot rub and/or roll your feet on a lacrosse or golf ball for a nice massage along your plantar fascia.
• Elevate your feet above heart level to reduce swelling in your feet.
• Wear shoes that fit you. If your nice shoes are giving you pain, you may need to put them away for the pregnancy. Instead, find athletic shoes that will give you comfort and support to protect your precious cargo from unstable situations. Additionally, it will prevent pain or swelling from uncomfortable footwear.
• Use orthotic inserts if your arches have flatten due to weight gain - Arch supports and good cushioning should do the trick.

If you feel that you are swelling excessively, or if the swelling is occurring unevenly (in one leg and not the other), contact your doctor right away. Swelling is not necessarily normal in all parts of the body and may indicate a more severe problem. If you are concerned about swelling in your legs or need assistance with finding relief, Dr. Jonathan M. Kletz of Texas Foot Works is more than happy to help you. Make an appointment today at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices.

Gymnastics is one of those sports, where the athletes make it look so easy. Unless you’ve tried it, you may think that it’s just something that you just need to practice. However, it takes years and years of training, conditioning, and strengthening to build muscles and have your body learn to move in that smooth, sleek fashion. It also takes trial and error, and more likely than not, injuries to the feet and ankles. That’s why gymnasts must learn early on, how to protect their feet and ankles to prevent injury. Not taking precautions, such as the ones listed below can lead to many painful injuries:

• Coaches should be made aware of any chronic or developmental issues, as well as any previous injuries.
• Strength, Balance, and Flexibility exercises should be taken seriously and gymnasts should make sure to do adequate warm-up before they practice, practice, practice their technique.
• Use tape or wraps to help with certain strains or injuries to the feet or ankles to prevent from worsening.
• Do not attempt new techniques without adequate preparation, the right safety equipment, and a confident attitude. Children, especially, should not be forced to try difficult or possibly dangerous techniques without a good mindset.
• See a doctor promptly if you sustain a severe injury. For mild sprains, use the RICE method (Rest, Ice, Compression, Elevation) to relieve pain. If pain persists or gets worse, make an appointment to see our podiatrist.

Not taking steps to reduce risk of injury can lead to serious injury. Gymnasts can expect to experience muscle soreness, in which recovery and hydration is key, but other conditions require more attention. Look for signs of the following common injuries:

• Sprained or Twisted Ankles – A loss of balance or improper landing can lead to an ankle injury. Most likely, there will be pain at the moment of injury or when the gymnast tries to put weight on it. If the pain and/or swelling is mild, try the RICE method. If the injury is severe, see a doctor immediately. 
• Stress Fractures and Acute Fractures – While broken bones are not as common as sprained, fractures can occur. Stress fractures can build under repetitive pressure while acute fractures can happen from an improper position or landing. If you cannot bear weight or have excruciating pain, see a doctor immediately.
• Overuse Injuries such as Achilles Tendonitis or Joint Pain – Certain repetitive motions, unprotected high impact landings, and lack of good technique or form can lead to many different overuse injuries. At the first sign of pain in any part of the body, it’s best to have it checked instead of ignoring it or “shaking it off” as it can get worse over time.

If you or your child has a gymnastics-related foot or ankle injury, make an appointment to come see us ASAP. Early treatment can mean better results so that we can have you back at practice. Dr. Jonathan M. Kletz of Texas Foot Works is more than happy to help you at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices.

Are you prone to injuring your ankles? For those who have weak or previously injured ankles, twists, rolls, sprains, strains, and even fractures can seem to happen often. It can occur while playing sports, hiking, running, and even walking (especially in high heels). Injuries at the ankle can cause pain, swelling, and tenderness. For the most part, the RICE (rest, ice, compression, elevation) method can help relieve symptoms, but if they persist, it may indicate a more severe issue.

Many of these injuries happen because ankles are not very flexible or strong. Lacking a strong sense of balance can also attribute to this, which is why the following exercises for stretching, strengthening, and balancing with your ankles will help you reduce risk of ankle injuries. Try to incorporate some of these exercises into your weekly workout routine, or do them as you watch TV or when you have other downtime:

(For those with repetitive movements, try to do 15 repetitions for 3 sets to get maximum results – increase reps as you can.)

Flex and Point: While sitting, stretch your legs out in front of you and flex and point, each for 3 seconds. To add a challenge, use a towel or band to increase resistance while pointing.

Calf Raises: Slowly lift up onto the tiptoes and slowly lower down.

Ankle Pushes: Place your foot against a heavy or stationary object like a couch or refrigerator. Push the outer part of the ankle against the object, then push the inner part of the ankle against the object, each for at least 10 seconds.

Heel Walking: Try to balance on your heels with your feet flexed (toes pointing up). Try walking across the room and back, resting in between each round-trip journey.

Balancing Bars: Stand next to a stable bar, such as stair railing, couch, or ballet bar. For first timers, hold the bar while you do some squats (feet facing forward) and then ballet pliés (with your feet pointing away from each other).

Yoga Tree Pose: Stand on one foot with the other foot resting flat against the ankle. Start by holding this position for at least 15 seconds. Switch and do the other side. To challenge yourself more, raise the non-standing foot to the inside of the other knee. A 3rd level of challenge is to raise the foot to the inside of the thigh.  

If you have ankles that are prone to injury, or if you have an injured ankle, it’s best to get it checked out to make sure it’s not serious. Before beginning exercises like those mentioned above, it’s best to consult with our podiatrist. Dr. Jonathan M. Kletz of Texas Foot Works is more than happy to help you with your ankles. Make an appointment today at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices.

Spring is well underway and summer is quickly approaching! This can mean a number of different things for you and your family, including flying on an airplane to your long-awaited vacation. Some folks actually enjoy the experience of flying, but for others, it can be the most dreadful part of the vacation experience.

To make your flight experience better, try this: Take care of your feet.

It’s not the first thing you think about, but foot care and related self-care on a flight can make a huge difference to your travel experience. It’s especially important on long flights, where sitting inactively for a long period of time can lead to edema (swelling) and cramping. Diabetics, pregnant women, and anyone prone to blood clots or other circulation disorders are at higher risk of edema and should pay attention to how their feet and ankles are doing during a flight.

The following are foot care and self-care tips for traveling on airplanes:

Foot-specific Care

• Wear shoes that are comfortable, breathable, and lightweight. Slip-on shoes will be great if you plan on taking your shoes off during the flight.
• On that note, make sure you have clean feet and a fresh pair of socks on – compression socks are even better to prevent swelling. If you will take your shoes off, do not be the person that inconveniences your neighbor. Additionally, it is best to reduce the chance of bacterial, fungal, and viral growth in your shoes, which is essential for foot health.
• Perform foot and ankle exercises while seated such as: pointing and flexing your feet, make circles with your feet, make windshield wiper motions with your feet, and spreading your toes out and then gripping them together.
• If you have short legs, use a bag or pillow to prop your feet. It will relieve some pressure and reduce chances of fluids pooling in your lower extremities.

Whole-body Care

• When booking a ticket, choose an aisle seat if possible. This will give you more room to stretch your legs out and give you freedom to walk up and down the plane as you please.
• Before boarding: Make sure you’re wearing comfortable clothes and shoes. If you have a sweater, it can be helpful in case it is cold on the plane. Drink water and use the bathroom. Do some full body stretches: reach to the sky on tip toes, bend over forward and back, as well as side-to-side.
• Get up and stand, move, walk whenever possible. If you’re not in the aisle seat, get out every time the person in the aisle seat gets up. This will help with overall circulation and prevent cramping.
• Pack healthy snacks/food, avoiding salty snacks. They can dehydrate you, which will increase risk of swelling. Drink plenty of fluids – which will also give you more excuses to get up and go to the bathroom.

Traveling with children? Do the same type of foot and whole body care for them. If you are worried about edema or foot care on an upcoming flight, make an appointment to come see us at Texas Foot Works. Dr. Jonathan M. Kletz can assess your feet and give you great solutions for your edema. Make an appointment today at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices.

There are some chronic foot issues that are not easily treatable with conventional methods. Diabetic foot ulcers, plantar fasciitis, tendinitis, and arthritis are chronic problems that do not always have a quick fix or simple treatment.

Good news! There is now a treatment option, in which platelet-rich plasma (PRP) is obtained from your blood, separated and concentrated, and then injected into or applied onto the problem site. Platelets are the part of the blood that release growth factors and other necessary healing components to mend issues in the injured tissue. The goal is to use the body’s own growth factors to accelerate the healing process. This autologous blood product is safe and accepted by your body since it comes from your own body.

Procedure Information

Once you’ve been deemed a good candidate for a PRP treatment, the Autologous Conditioned Plasma (ACP) system will be used for the procedure.

·      A double syringe system is used to draw up blood, which is then placed in a centrifuge.

·      The centrifuge separates the platelets from the red blood cells

·      The platelets are then applied back into the injury or pain site.

It takes much less time to obtain the ACP in this system than it does for typical PRP systems, which can take up to 45 minutes. It is also safe since the whole process takes place in a closed system, significantly lowering risk of infection or other contamination issues.

For diabetic foot ulcers that take up a lot of time to close or won’t heal properly, another way to use PRP is to use a system that creates a gel that is applied directly over the open wound to encourage healing. 

Better Healing

The goal of the treatment is to speed up healing time or reduce pain and have you return back to normal activities sooner, especially for muscle or tendon injuries. Surgeons may also apply PRP to injuries to aid recovery after a sports injury that required surgery. In this way, PRP is not usually a standalone treatment, but instead, recommended with other rehab treatments like physical therapy and/or the use of orthotics or other devices.

Do you have chronic issues and wonder if you’re a good candidate for PRP treatment? Make an appointment to come see us at Texas Foot Works. Dr. Jonathan M. Kletz can assess your feet. Make an appointment today at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices.

Did you know that babies are usually born with flat feet? Their chubby little feet have padding to protect them, which means that there is no arch on the bottom of the feet. But don’t fret! It’s usually a problem that begins to resolve itself as they begin to stand or walk. As their feet begin to strengthen, the tissues along the bottom of the feet begin to tighten and an arch forms.

The problem, however, occurs when the arch does not form. Then, the child has pediatric flatfoot. Depending on the severity of the issue, the child may outgrow it or it may develop into a painful problem. The flexible type of flatfoot can be treated more easily, but a rigid flatfoot issue would require more corrective treatment. Treating this early would be beneficial to the child, especially if the child experiences pain or discomfort while walking, cramping, or in-toeing.

If there is no pain, your child may grow out of it, and no treatment is necessarily required. On the other hand, if there is pain or discomfort, it is best to have feet assessed as soon as the problem is detected. Our podiatrist may suggest one of the following treatments:

• Orthotic Insert, shoes, or devices– for flexible flat feet, shoe inserts can help support the feet at the arches. Custom shoes or orthotic devices may be required to support the arches. Rigid flat feet can be affected worse by shoe inserts, so it is not recommended.
• Stretching exercises – if the flat feet are caused by tight heel cords, special stretching exercises may be required to lengthen the heel cord.
• Surgery – when no other treatments work, surgery may be required, especially in truly rigid flat feet.

Leaving painful flatfoot untreated could lead to worse problems later, such as arthritis. If your toddler seems to be complaining of pain, refuses to walk, or wants to be picked up all the time, it’s possible that they may have foot pain such as flat feet. Make and appointment to come see us at Texas Foot Works. Dr. Jonathan M. Kletz can assess your child’s feet to find the right solution for relief. Make an appointment today at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices. 

You wake up in the morning, take your first steps out of bed, and feel pain along the bottom of your feet. You also feel the same pain after some intense exercise or sitting for a long period of time.

You’re probably suffering from plantar fasciitis. This is caused by an inflamed, overused, tired ligament network along the bottom (plantar) of the feet. These tissues connect the front of the feet to the heels. Those who overpronate, have fallen arches, or overuse the tissues from working or exercising can experience this problem.

Plantar Fasciitis Pain Relief

The following are some at-home remedies you can try to get relief from plantar fasciitis pain:

• Stretch – Before you get out of bed in the morning, sit up, flex your feet, and reach to your toes to stretch the plantar fascia and calves.
• Rest and Ice the Plantar Fascia – Overuse injury is a common cause of plantar fascia pain. Reduce activity and use ice packs or cold compresses several times throughout the day to reduce inflammation.
• Relax and Relieve Tension – A warm foot soak or foot massage can feel great for tightness along the bottom of the feet.
• NSAIDs (Non-steroidal anti-inflammatory drugs) – Over-the-counter ibuprofen or naproxen can provide pain relief and reduce inflammation.
• Orthotic inserts or shoes – These can be purchased at drugstores or pharmacies, but if specific shapes are required, it is best to get custom orthotics made by a podiatrist. The padding, arch and heel supports, and well-constructed shoes can help to stabilize feet and ankles to reduce strain on the plantar fascia.

Prescribed Treatment Options via Podiatrist:

• Physical Therapy – This can help reduce tension and strengthen the feet to prevent further pain.
• Surgery – This is a last resort for those suffering from persistent pain, where other treatments have not worked.  

Plantar fasciitis got you down? Come see us at Texas Foot Works. Dr. Jonathan M. Kletz can assess your feet to find the proper treatment for you. Make an appointment today at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices!

When dancers begin to perfect their art, the first few things they realize are difficult to deal with are the choreography, grueling hours of practice, and foot issues due to their shoes and positions they have to be in. So for someone to become a dancer, they quickly realize that it takes more than just practice and talent.

The feet, ankles, and legs play a vital role in dancing. Ballet, tap, jazz – you name it – all of these types of dance require you to use your lower extremities in non-typical ways. At the end of long periods of practice or a long showcase performance, the feet and ankles can be in pain and have all sorts of issues like strains, cuts, and even fractures!

There are many foot and ankle injuries both professional and amateur dancers may be prone to encountering. Typical injuries include:

• Achilles tendon injury or tendonitis – The tendon on the back of the heel is susceptible to injury, especially in quick movements or in repetitive movements that chronically inflame the Achilles tendon.
• Ankle Sprains – Sharp movements that overstretch ligaments in the ankle are called ankle sprains. A misstep or fall can cause an ankle sprain.
• Corns and Calluses – Depending on the shoes worn, pressure on certain parts of the feet can result in corns or calluses, which are thickened patches or bumps of skin. These areas can become inflamed and cause pain.
• Fractures – Constant pressure on bones can cause small lines of bone breakage. Many repetitive movements can ultimately lead to painful fractures.
• Hammertoes – Those that go “on point,” especially ballet dancers, can form hammertoes due to the pressure places on the toes when they go on tip toe. These can be painful, but can be fixed if caught early on.
• Plantar Fasciitis – Because of repetitive movements in dance practice, it’s possible to cause inflammation and irritation along the bottom of the feet. This is one issue where rest is important for relief.
• Ingrown Toenails – As with hammertoes, when there is much pressure on the top of the toes with the toenails, it can cause ingrown toenails, which can be painful as the nail grows into the skin.
• Metatarsalgia – The ball of the feet, especially near the big toe joint can become painful and inflamed as an overuse injury because of the repetitive movements that dancers perform.

In addition, dancers must keep strengthening and conditioning their feet so that they can prevent injury. They must also keep good hygiene to prevent infections and even odor issues. Shoes must fit well so that they can be supportive of the different moves or positions they need to perform.

Have pain from dancing? Come see us at Texas Foot Works. Dr. Jonathan M. Kletz can assess your feet to find the right solution for relief. Make an appointment today at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices. 

Those who experience foot cramps often will tell you that it’s no day in the park. The sudden, involuntary muscle contraction can cause extreme pain and even limit mobility of the feet or ankles. For some, cramps can happen very suddenly, without warning. For others, they can happen after a workout or a long day of standing or walking.

There are many possible causes, depending on individual situations. Below are some reasons why you may be getting foot cramps.

• Nerve Damage or Compression – If a nerve is being pressed or is damaged from injury, it is possible that the signals to the brain are interrupted and muscle contractions happen for a longer period of time than intended.

• Muscle fatigue or overuse – Long periods of muscle activity can lead to cramps. Warming up, stretching, and cooling down are helpful to prevent cramps due to intense activity. 

• Dehydration – Fluids are required to properly use muscles. When you are dehydrated, the muscle may not function properly and leave you with a prolonged contraction. Some medications can cause dehydration as a side effect, so be sure to stay on top of drinking fluids when on these medications.

• Nutritional Deficiencies – Calcium, Vitamin B, Vitamin D, Vitamin E, Magnesium, and Potassium are all required for healthy muscle function. Eat your vegetables and get in the sun!

• Lack of support in footwear – When shoes do not give adequate support to the feet, muscle tissues may have to strain to support them. This strain can lead to a muscle cramp, depending on how your feet position themselves to support you.

• Pregnancy – Your body undergoes many changes during pregnancy. You are more susceptible to swelling feet, which may press on nerves or reduce circulation.

• Other health issues – If you have severe foot cramps, they may indicate that you have other health issues.

When you have a foot cramp, one way to relieve pain is to flex your foot. Pull the toes toward you to relax the muscles. If you have prolonged pain, you may need a massage and a warm foot soak. Otherwise, if your feet swell, you may need a cold compress to ease the pain and alleviate the inflammation.

Have you been experiencing foot cramps? Come see us at Texas Foot Works. Dr. Jonathan M. Kletz can assess your feet to find the cause and prescribe you the appropriate treatment. Make an appointment today at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices!

When was the last time you gave your feet some love? A foot rub or pedicure can go a long way to aid aching or sore muscles and to relax any tension. After all, your feet carried you all day and helped you get you where you need to be. This month, we encourage you to take special care of your precious feet to prevent issues down the road. Here are our top tips for foot care:

Daily Tips

• Wash your feet each day, even if you’re not showering every day. Not only will warm water help to soothe any aches or soreness, it will also help provide another check for any changes in your feet. Use soap and warm water (don’t forget in between the toes!) to fight fungi and bacteria, and then dry your feet completely before putting anything on them.
• Assess your feet after washing. Treat injuries with first aid and look for skin changes or new bumps.
• To prevent bacterial or fungal infections and foot odor, rotate the shoes that you wear so that they have time to fully dry out after each wear.
• If you stand or walk a lot during the day, stretch your feet and give them a quick rub to relax them.

General Foot Care Tips

• If you get pedicures, make sure the tools that are used are sterilized. The first appointment of the day is a good way to ensure that.
• Wearing nail polish for a long stretch of time can weaken the toenails. Take a break between pedicures.
• Wear shoes that are the right size and shape. Shoes should fit your feet, not the other way around. Don’t buy shoes that need to be broken in, as some materials do not stretch out. Supportive padding and heel cups will prevent problems caused by strained muscles tissues. Have a foot condition that needs extra support? Orthotic inserts will do the trick – ask your podiatrist.
• Toenails should be trimmed straight across not too short to prevent problems with ingrown toenails.
• Wear flip-flops in communal shower and pool areas to prevent the contraction of contagious infections from bacteria, fungi, and viruses.
• Don’t forget to put sunblock on your feet! There is skin there too, and at risk of burning!
• Eat healthy and exercise. If you have other conditions like diabetes, make sure to control your blood sugar levels to maintain healthy feet.

Wondering how your feet are doing? Come see us at Texas Foot Works. Dr. Jonathan M. Kletz can assess your feet to make sure your feet are healthy. If you are worried about a foot health condition, we can help too! Make an appointment today at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices!