December 2017

More than anything, smelly feet can be embarrassing. To remedy the situation, you need to take your feet out of your shoes, but if you do, people around you might smell the horrid odor. So you continue to do your best to hide it. But did you know that it makes the smelly feet situation worse?

Your feet have about 3,000 sweat glands per square inch of feet. As you get hot throughout the day, your body uses these glands to release heat, making parts of your body sweaty. Some people may not sweat as much through the hands and feet, instead releasing heat through the head, armpits, and/or back. For everyone else, hands and feet can easily get sweaty, and cause problems when they are covered. In these cases, sweat leaves through the feet and into the socks. When socks are drenched in sweat, it can then cause dampness in the shoes’ inner lining, causing stinky feet, socks, and shoes. The damp and dark environments are the perfect breeding ground for bacterial and fungal growth – and they are the reason for the smell.

While this issue can be embarrassing, not addressing the issue can cause worse issues. Bacterial or fungal infections can lead to inflammation and pain, or worse, foot ulcers. Foot odor is a problem that occurs to anyone as a natural process of the body, but there are ways to deal with it. The following tips may be helpful, especially for folks who may have hyperhidrosis (excessive sweating), are taking certain medications, or are experiencing hormonal or stress issues:

• Rotate shoes and let them dry out completely each time you wear them. A bit of baking soda or baby powder can help to reduce moisture.
• Wash your feet every day with warm water and soap to reduce the chance of bacterial infection. Dry your feet completely and put on new socks. Never re-wear your socks.
• Inspect your feet daily for any rashes or other signs of bacterial or fungal infections.
• Wear socks whenever you wear closed-toed shoes. If you sweat excessively, bring another pair with you to change socks midday. Moisture-wicking breathable socks are best for preventing dampness in the shoes.
• Ask a podiatrist if you should apply foot sprays or foot powders.

Dr. Jonathan M. Kletz at Texas Foot Works can help you find other ways to deal with your persistent foot odor, as well as see if you have another underlying proble. Make an appointment at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices so that he can assess your needs and get rid of your stinky feet! 

Have you tried yoga yet? In recent years, many have benefitted from practicing Yoga. It is good for the mind and body, helping you to focus, strengthening your muscles, and improving your balance. For your feet in particular, it can be helpful in becoming more aware of two body parts that constantly carry the whole of you around. (Note: If you haven’t practiced yoga before, it is best to begin under the guidance of a Yoga instructor for proper alignment and form to prevent injury.)

Are you ready to connect with your feet and challenge your body to go beyond your daily movements? Try some of these poses to test the flexibility, endurance, and strength of your feet. Remember that pain is not a part of yoga, so only push as far as you are comfortable.

• Tadasana (or Mountain Pose): You may feel like all you are doing is standing. That’s right. This is a standing pose where you feel out how the feet touch the ground and support the entirety of your body. Are you swaying or leaning on one side or the other? Make sure you are balanced. For a challenge, try stretching out your toes wide or lifting them up.
• Tree Pose: Balance on one leg with your other foot against your ankle. How is your balancing foot compensating? Do you put more of the weight on the inner or outer side of your foot (do you over- or under-pronate)? Try to shift the weight evenly on your foot. For a challenge, raise your elevated foot to inside of the knee or thigh, as well as raising your arms above your head, like a tree.
• Hero Pose: This is usually considered an uncomfortable sitting position. However, it is a great way to stretch your ankles and quads. For a challenge, tuck your feet and toes under your bottom, so that your toes are bearing your weight instead of the top of your feet. Where are your pinkies? Did they follow suit? You may have to help tuck them under!

Practicing Yoga often can help your body feel rejuvenated and relaxed from stress or tension. After some of these moves, you may become more aware of your feet and appreciate how much work they do in each pose. You may begin to notice what role your feet play in any activity you do, even when simply walking or standing. Strengthening your feet and improving balance can only improve your feet and ankle health, but pain should not be a part of it. If you notice some pain when you try Yoga or in any other activity, come see our podiatrist, Dr. Jonathan M. Kletz at Texas Foot Works. Make an appointment at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices so that we can assess your needs and treat them properly! 

Summary: Final Rule Implementing Section 1557 of the Affordable Care Act

The Department of Health and Human Services (HHS) issued the Final Rule implementing the prohibition of discrimination under Section 1557 of the Affordable Care Act (ACA) of 2010. The Final Rule, Nondiscrimination in Health Programs and Activities, will help to advance equity and reduce health disparities by protecting some of the populations that have been most vulnerable to discrimination in the health care context. The final rule explains consumers’ rights under the law and provides covered entities important guidance about their obligations.

Section 1557 prohibits discrimination based on race, color, national origin, sex, age or disability in certain health programs and activities.

Section 1557 builds on long-standing and familiar Federal civil rights laws: Title VI of the Civil Rights Act of 1964 (Title VI), Title IX of the Education Amendments of 1972 (Title IX), Section 504 of the Rehabilitation Act of 1973 (Section 504), and the Age Discrimination Act of 1975 (Age Act). Most notably, Section 1557 is the first Federal civil rights law to prohibit discrimination on the basis of sex in all health programs and activities receiving Federal financial assistance.

Section 1557 has been in effect since enactment of the ACA in 2010 and the HHS Office for Civil Rights (OCR) has been enforcing the provision since it was enacted.

Coverage of the Rule

The rule covers:

− Any health program or activity, any part of which receives funding from HHS (such as hospitals that accept Medicare or doctors who accept Medicaid);

− Any health program that HHS itself administers;

− Health Insurance Marketplaces and issuers that participate in those Marketplaces.

Attention: If you speak any of the listed below languages – language assistance services, free of charge, are available to you.

Please call:   State Health Insurance Assistance Program Language Line 800-792-8820

The Superbowl is right around the corner! The Cowboys are in the running for the playoffs and it looks like they’re getting healthier than they have been all season. Whether the Cowboys make it to the Superbowl will be determined by the Championship game, which in turn, may depend on how injuries play out.

While the Cowboys mostly have healthy players, those who have been injured previously are a concern. Morris Claiborne is back in action, but will he continue to play for the Cowboys? His extensive injuries leave him an uncertain player in the football world. Terrell McClain’s ankle injury in December left him out of games, but recently returned to practice. Cedric Thornton also suffered a sprained ankle, but is hoping to play in the playoff game. This is good news for the Cowboys, but precautions need to be taken.

Re-injury is a real possibility

Injured players often return to practice and game time too soon, leaving athletes at risk of re-injury. As a full contact sport, the risk is high for not only re-injuries, but also for making a previous problem worse. A small ligament tear can become even bigger and a sprain can become a chronic issue. Due to the wide range of movements that football players must perform, there’s no way to perfectly prevent injury, even with the proper shoes, protective gear, and helmets.

With practices throughout the season and games scheduled very often, repetitive use of certain muscles and tissues is inevitable. Even though they know to stretch, warm up, and take necessary precautions, they still have a high probability of overuse strain, making the athlete more prone to injury. Chronic issues can also develop, as well as possible stress fractures. Turf Toe, Plantar Fasciitis, Sesamoiditis, Ankle Sprains and other bone and tissue issues commonly arise for football players because of the nature of the sport.

Will the Cowboys take it all the way to win the Superbowl? We’ll see how injury can be a factor in the outcome, especially if the opposing teams have sustained injuries as well. If you’ve been playing football as well, and sustained injuries, come see our podiatrist, Dr. Jonathan M. Kletz at Texas Foot Works. Other sports injuries can also leave you with overuse or chronic pain issues. Make an appointment today at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices so that we can assess your needs and treat them promptly! 

Keeping our older loved ones active and mobile is essential to keeping them healthy. It affects not only their physical health, but also their mental health by giving them a sense of independence. Supportive footwear plays an important role in keeping older adults safe in their mobility. Promoting balance, maneuverability, and cushioning are key features of supportive footwear for seniors, who are at a higher risk of falls.

If your loved one seems to be struggling with walking or is at high risk for falls, follow these tips for finding supportive footwear for older adults:

• Shoe structure and outer soles: Find shoes for the right environment. If they need support indoors, appropriate shoes will vary depending on if they have carpets or hardwood floors. Outer soles with grip/tread will get caught in high-pile carpeting, but are optimal for hardwood or other smooth floors. In carpeted areas, smooth outer soles will prevent tripping. Shoes should be made of breathable material, especially if seniors will wear indoor shoes for long periods of time. For outdoor footwear, outer soles should provide grip to prevent slipping on wet floors. Materials should be breathable and lightweight but tough. Heavy shoes will weight them down.
• Toebox: The front of the shoe where the toes engage the shoe is called the toebox. You should find shoes that will fit the shape of your older adult’s toes, including any bunions (or other deformities they might have). Otherwise, toeboxes that are too narrow and shallow will cause pain, while toeboxes that are wide and tall will leave space for possible blisters. Toes need room to wiggle, but should not slide around in the shoes.
• Arch support: Arches should be supported by a tough but cushiony midsole. The shoe should not be able to twist at the middle, nor should it be able to bend in half.
• Heel cups: The heels of the feet should fit snuggly into the cushiony heel cups. They should feel supported by the rigidity of the back of the shoes. Heels that fit well will prevent blisters and instability when moving. 

Because feet can keep shifting and changing, it is best to try on shoes before buying them, or be willing to return shoes that do not fit well. If possible, measure feet each time you go to the shoe store, including the width of the feet. Some feet can swell, while others can shrivel up.

In some cases, your older loved one may need orthotic inserts to best support their needs. Come see our podiatrist, Dr. Jonathan M. Kletz at Texas Foot Works with questions or concerns about balance or foot pain. Make an appointment today at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices so that we can assess and assist you and your family. 

How are you doing on your New Year’s Resolutions? They are not always so easy to keep, but we at Texas Foot Works want to encourage you to keep going!

If your resolution(s) had something to do with getting in shape or engaging in a healthy, active lifestyle, we have some tips for you to help increase your step count! The weather has been fluctuating, but try to keep consistent with your activity while taking the proper precautions to keep you safe and warm in the winter weather (or cool during warmer days).

• Got a pedometer, activity tracker, or smartphone with activity tracking capabilities? Put them to use! You may be surprised at just how sedentary our lifestyles can be, especially if you work in an office in front of a computer all day.
• Set reasonable step/activity goals. Start slow but increase your step goals as you get better at it.
• Put things on the far end of the room or space. Be less efficient. What do we mean? Put your alarm clock on the other side of the room. Leave the water pitcher in the kitchen so that you have to get up to refill your glass each time. Set the printer far away in the office, rather than right next to your desk. Park at the far end of the parking lot (plus, you’ll probably find a parking space faster this way).
• Exercise in place. Do this while working, watching TV, or on the phone. Stretch, walk in place, do squats, or just do sets of tightening your abs instead of simply sitting. You could try to get a standing desk, stability ball chair, or even a pedal exerciser to put under your desk.
• Find opportunities to walk, instead of having machines do the work for you. For example, take stairs instead of elevators or escalators.
• Take a walking lunch. Whether you work from home or in an office downtown, walk to get your lunch. You can also start or join a walking group and then eat at your desk afterwards.
• Take the stairs instead of using an elevator or escalator.

Do you have pain while walking or staying active? Don’t let it get you down. Instead, make an appointment today to see our podiatrist, Dr. Jonathan M. Kletz at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices. 

Happy New Year! Have you made your list of resolutions yet? Most of them are probably related to self-improvement, like losing weight or eating healthier. This year, in addition to those goals, how about you put a focus on your feet? At Texas Foot Works, we want to encourage our patients to prioritize foot health so that you can achieve overall health.

Here are some goals you might add to your list of New Year’s Resolutions:

• Make your annual podiatry appointment with your favorite podiatrist! Why put off ‘til tomorrow, what you can do today?
• Listen to your body, especially your feet and ankles! If you have pain, it is best to address it and take care of it instead of “powering through.” Prevent further injury or issues by using proper equipment and braces if you already have chronic foot or ankle pain.
• Take care of your corns, calluses, and any other dry skin issues that you may have been ignoring. Don’t forget to moisturize your feet (along with the rest of your body) after you shower.
• Find the shoes that fit you best. While shoes may all seem the same, there are subtle details that can make all the difference in foot comfort. Get measured each time you buy shoes and pay attention to any discomfort. Don’t buy shoes that will “break in” because if they don’t, you’ll be stuck with shoes that may give you problems later.
• In the same vein, get rid of your old shoes. Stop wearing shoes that are uncomfortable and pain inducing.
• Stretch and strengthen those feet. If you need a suggestion for a new activity to take on this year, try Yoga: you’ll improve your feet and ankle’s flexibility, strength, and balance.
• Do more. This doesn’t mean get busier. We mean, get more active and find ways to increase your step count. If you received a pedometer or activity tracker as a gift for the holidays, now’s the perfect time to use it! Take the stairs instead of the elevator. Park far away from the grocery store or work. Go on walks while you talk on the phone.

If you follow some, if not all of these tips, you may begin to notice just how much work your feet and ankles have to endure. Reward them with a nice massage or foot soak to improve your mood, circulate fluids, and feel relaxation from the bottom of your feet to the top of your head.

Have questions or concerns? Ready to book your annual podiatry appointment? Make an appointment today to see our podiatrist, Dr. Jonathan M. Kletz at any of our Abrams (Dallas), Athens, and Gun Barrell City, TX offices. 

Have you ever gotten up from a chair or out of bed in the morning, and upon taking that first step, feel like your heel has stepped on a tack? Many people experience a feeling of sharp pain which radiates into their arch from their heel and which does not allow them to put their heel on the floor. Sometimes they need to sit back down, stand only on their toes and use the wall for balance. If you can take a few steps, it seems to go away and lessens, allowing you then to resume your activity. Later, throughout your day and after a period of rest, it can happen again. If this sounds familiar you may be suffering from your first attack of heel pain.

Diabetes can the loss of sensation in the feet. This can result to foot injuries caused by cuts or bruises due to the loss of feedback and sensation. Diabetes can reduce the blood flow to your feet. This is because of the high levels of blood sugar. Without normal blood flow to your feet, injuries heal slower due to the loss of nutrients.

Proper foot care is essential, especially for people suffering from diabetes. Consult a podiatrist for more information on proper foot care for diabetics. Dr. Jonathan Kletz is a podiatrist who specializes in helping people with foot disorders.

• Inspect your feet every day.
• Check your feet for any cuts or swellings. You may have a foot problem but you can’t feel any pain in your feet.
• When you take your shoes off every night, check your feet. Use a mirror if you are having trouble inspecting your feet.
• Clean your feet every day.
• Wash your feet in lukewarm water. Avoid soaking your feet because it will get dry.
• After washing your feet, use talcum powder to keep the skin between your toes dry.
• Keep the skin smooth and soft.
• Use lotion, cream, or petroleum jelly on top and bottom of your feet.
• Avoid putting lotion in between your toes that might lead to an infection.
• Gently smooth corns and calluses.
• If you have corns and calluses, ask your foot doctor the best way to care for them.
• Rub the pumice stone gently only in one direction to avoid any tearing of the skin.
• Cutting the corns and calluses is not allowed because it can damage your skin and might lead to an infection.
• Trim your toenails regularly.
• After you wash and dry your feet, trim your toenails using a nail clipper.
• Do not cut into the corners of the toenails.
• Wear socks and shoes all the time.
• Avoid walking barefoot when inside or outside.
• Wear socks with your shoes to prevent blisters and sores.
• Choose socks that have no seams, are clean, lightly padded, and fit well.
• Before you put your shoes on, check the inside and make sure that there are no foreign objects in your shoes.
• Wear a shoe that protects your feet and fits well.
• Things to remember
• Set a time to check your feet every day.
• Always wear socks and shoes.
• Stop smoking.
• Have a regular appointment with your doctor.
• Schedule a date for taking care of your feet.
• Prevent foot problems by managing your diabetes.

Texas Foot Works located in Dallas, Athens and Gun Barrell City, TX, we specialize in helping people with foot disorders. To schedule an appointment, call 214-340-8885.   

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Did you know that the strongest tendon in the body is the Achilles tendon? This tendon connects your lower leg muscles and calf to the heel of your foot. It is also responsible for facilitating movements such as walking and running. The Achilles tendon gives the body provides mobility for major leg and foot movements. And any injury should be treated as soon as possible to prevent serious and complicated problems.

Most common symptoms of the Achilles tendon disorder

Achilles tendinitis. This is the milder injury of the Achilles tendon and manifests the following signs and symptoms:

• Pain that ranges from dull to severe
• Inflammation
• Increased blood flow to the tendon
• Slower movement
• Thickening tendon

Tendinitis can be diagnosed by an MRI or the Magnetic Resonance Imaging and it can also be treated using several methods.

Achilles tendon rupture. When your Achilles tendon ruptures, you feel the most intense of pain. And it is also harder to heal compared to tendinitis. A rupture occurs when a tendon completely snaps or rips. The result of the rupture will occur immediately and can make you immobile. However, be assured that when rupture occurs, there are operative and non-operative treatments available. The recovery time will depend on the severity of the injury but usually takes up a year after treatment begins.

Consult a podiatrist for chronic foot pain which can be an indication of an injury. Dr. Jonathan Kletz is a podiatrist who specializes in helping people with foot disorders.

You can do simple preventive measures to avoid both of the above injuries. Here are some of the helpful tips that you can do to prevent Achilles tendon injuries (always check with your doctor first):

• Before doing any movement, do some stretching of the tendons to help stimulate the tissue for a few minutes. The following exercises will help strengthen your lower legs and promote good health for your Achilles tendon:
• Calf raises
• Leg curls
• Squats
• Lunges
• Leg extensions
• Leg raises
• Leg presses
• Do not over exert while exercising and do proper warm-up before any physical activities that might stress your Achilles tendon.
• Wear proper and comfortable shoes that correctly fits to reduce tendon injuries
• When exercising, ensure that your activity area is cushioned or has a mat as it will help relieve pressure on your heels.
• Have a healthy diet.

If you suspect or if you already know that what you are having is an Achilles tendon injury, it is best and very important to consult your podiatrist immediately. This will help you prevent the injury from getting more complicated. Keep in mind that severe complications can lead to difficulty in movement.

Texas Foot Works located in Dallas, Athens and Gun Barrell City, TX, we specialize in helping people with foot disorders.  To schedule an appointment, call 214-340-8885.