Those Pesky Calluses!

Dr. Rosenstein,


      How can I get rid of calluses and prevent them from coming back?


Calluses, those hardened patches of dead skin cells formed from keratin that generally develop on the ball or heel of the foot, can actually protect the feet and often do not need to be treated.


The skin on the sole of our feet is actually forty times thicker than skin anywhere else  and a callus can be double this thickness. A protective callus layer naturally develops to guard against excessive pressure and chafing as people age and the padding of fat on the bottom of the foot thins out.


Calluses develop from wearing poorly fitting shoes and walking on hard surfaces. People with diabetes should be extremely careful as calluses can be a strong predictor of subsequent ulceration.


If the callus is causing pain, there are several treatments. You can sand callus with a pumice stone after bathing. Soft cushions can be placed in the heel of the shoes or under the ball of the foot to relieve pain. You can purchase special fitted shoe inserts.


Creams and special ointments can be used to effectively prevent and remove calluses.


If your calluses are well developed , then  professional attention is needed. Consult your podiatrist for proper treatment.


"When your feet hurt, you hurt all over!"


For more information or to schedule an appointment please contact Affiliated Podiatrists, Inc. at
440-946-5858 or visit our website http://www.drrobertrosenstein.com/

Getting Cold Feet............Literally?

Dr. Rosenstein,


      My feet are cold all the time and it's very uncomfortable. What causes this and what can I do?



Cold feet can be a result of poor circulation. As we age, the blood vessels sometimes develop plaques that restrict the blood flow to the feet.

Or sometimes the feet get sweaty and this moisture causes the foot to feel cold. You can wear a sock that wicks moisture away if that is the case.

Nerve problems in the foot can also give a cold sensation and may be painful at times. This condition is called peripheral neuropathy and is frequently seen in people with diabetes, peripheral vascular disease or other prolonged illlnesses.

Peripheral nerves are the nerves that go out from the brain and spinal cord to the muscles, skin, internal organs, and glands. The most common symptoms of neuropathy include numbness and loss of feeling, usually in the feet and hands. Peripheral neuropathy inpairs proper functioning of these sensory and motor nerves.

If you are having difficulty with this condition, consult with your family podiatrists.

For more information or to schedule an appointment please contact Affiliated Podiatrists, Inc. at:
440-946-5858 or visit our website www.DrRobertRosenstein.com

And remember........When your feet hurt, you hurt all over!

Tarsal Tunnel Syndrome

Dr. Rosenstein,

      My friend thinks I may have Tarsal Tunnel Syndrome because of the pain I am experiencing in my ankle. What exactly is Tarsal Tunnel Syndrome?


It is when the nerve that runs through the narrow passage behind the inner ankle such as a sprain or fracture or  by a growth that presses against the nerve.

Tarsal Tunnel Syndrome can be very painful and is caused by injury to the ankle such as a sprain or fracture or by a growth that presses against the nerve.

A conservative treatment for Tarsal Tunnel Syndrome is orthotics, or specially designed shoe inserts that help redistribute weight and take the pressure off the nerve.

Orthotics are shoe insoles that are actually molded from taking a plaster cast of the individual's foot. They can be rigid, soft or semi-rigid.

In addition to Tarsal Tunnel Syndrome, orthotics are helpful in correcting and treating many foot disorders.

They can help control motion in foot joints that lie directly below the ankle. They help prevent turning of the foot and are helpful for people who are very overweight or who have uneven leg lengths.

Keep in mind that orthotic insoles are not transferabl. They are customized for the individual and their particular disorder and could do more harm than good if used by someone other than the intended patient.

If you think that orthotics might be helpful to you, check with your podiatrists.

For more information or to schedule an appointment please contact Affiliated Podiatrists, Inc. at
440-946-5858 or visit our website: www.DrRobertRosenstein.com

And Remember......"When your feet hurt, you hurt all over!"

Pregnancy = Foot Pain?

Dr. Rosenstein,

         Since I have been pregnant I am experiencing pain in my legs and feet. Is this normal? How can I relieve the pain?



Pregnancy triggers many different changes in a woman's body. One of those changes is foot pain. Due to the natural weight gain during pregnancy, a woman's center of gravity is completely altered. This causes a new weight bearing stance and added pressure to the knees and feet.

Two of the most common foot problems experienced by pregnant women are over-pronation and edema. These problems can lead to pain at the heel, arch, or ball-of-foot.

Over-Pronation, also referred to as flat feet, is caused when a person's arch flattens out upon weight bearing and their feet roll inward when walking. Over-pronation can make walking very painful and can increase strian on the feet, calves and/or back.

Edema, also referred to as swelling in the feet, normally occurs in the latter part of pregnancy. Edema results from the extra blood accumulated during pregnancy.

Over-Pronation can be treated conservatively with "ready-made" orthotics. Proper fitting footwear is also very important in treating over-pronation. Choose comfortable footwear that provides extra support and shock absorption.

Edema in the feet can be minimized by the following methods:

• Elevate your feet as often as possible. If you have to sit for long periods of time, place a small stool by your feet to elevate them.
• Wear proper fitting footwear. Footwear that is too narrow or short will constrict circulation.
• Have your feet measured several times throughout your pregnancy. They will probably change sizes.
• Wear seamless socks that do not constrict circulation.
• If you are driving for a long period of time, take regular breaks to stretch your legs to promote circulation.
• Exercise regularly to promote overall health; walking is the best exercise.
• Drink plenty of water to keep the body hydrated. this helps the body retain less fluid.
• Eat well-balanced diet and avoid foods high in salt that can cause water retention.

For more information or to schedule an appointment please contact Affiliated Podiatrists, Inc. at
440-946-5858 or visit our website: www.DrRobertRosenstein.com

And Remember......"When Your Feet Hurt, You Hurt All Over!"

Foot Stress Fractures From Sport Injuries

Dr. Rosenstein,

      My son plays a lot of sports and I am concerned about the wear and tear on his feet. He recently experienced a stress fracture, and he seems to want to ignore it. What is the best treatment?


People who engage in high impact aerobic exercise or sports are certainly at risk for stress fractures and other foot injuries.

Stress fractures can occur as a result of prolonged repeated loads on the legs. Long distance runners are susceptible to this type of injury. Symptoms include:

• Pain in the affected bone during exercise.
• Tenderness and swelling at a point on the bone.

Stress fractures in athletes occur mainly in the lower leg and foot (in the calcaneus, navicular and metatarsal bones). A stress fracture of the second or third metatarsal bone is sometimes called a "march fracture" because soldiers running in boots often get it!

A mildly pronoted (flattened) foot in normal conditions would not develop and a stress fracture, but a runner with a mildly pronated foot could very easily sustain a stress fracture by repetitive usage on an altered biomechanical foot.

Stress fractures usually take time to develop and the symptoms are pain, redness and swelling. X-rays are usually only positive after about three weeks of symptoms. In some cases, a bone scan is necessary to make the diagnosis.

Treatment for a stress fracture like most conditions of the foot requires immobilization, ice compression. Rest for 6 to 8 weeks if a stress fracture is suspected. Use crutches if necessary. Athletes should see a podiatrists for advice.

Orthotics are the best treatment for long-term control of stress fractures. Immediate control would consist of a cast boot.

When the athlete does start back running they must ensure the muscles in the lower leg are stretched and supple. Many people start back running and complain of pain because they have let their muscles get hard and tight particularly in the lower leg.

For more information or to schedule an appointment please contact Affiliated Podiatrists, Inc. at:
440-946-5858 or visit our website: www.DrRobertRosenstein.com

Wearing The Right Shoes For The Right Job!

Dr. Rosenstein,

       I enjoy running as an exercise. Is there anything I should do so that I do not over stress my ankles and feet or cause injury?


First, you should gradually work up to the distance and speed you are comforatble running.

Of course, the shoes you choose are very important and they should be regularly replaced. The best shoes are ones that give you the greatest amount of shock absorption.

And a lot depends on how much you run and what speeds. If you are running 20 miles a week or more, you should replace your shoes between 4 and 8 months.

There are stretching exercises also that can help reduce pain and injury. Runners frequently experience tightness in muscle groups.

The calf should be gently stretched as well as the hamstrings. Stretch one set of leg muscles at a time with the "wall stretch". One leg is back, knee striaght, the other leg is forward with the knee bent. The leg that is back is being stretched. Doing this 10 times holding for ten seconds each is ideal.

There are many more stretches to loosen muscles and help you avoid any type of serious injury.

For more information or to schedule an appointment please contact Affiliated Podiatrists, Inc.
at: 440-946-5858 or visist our website: www.DrRobertRosenstein.com

And remember........."When your feet hurt, you hurt all over!"

Wearing The Right Size Shoes Can Prevent Foot Pain!

Dr. Rosenstein,

      My husband is a diabetic and he likes to wear his shoes snug. Is this okay or what advice would you give him?



Wearing the correct size shoes is extremely important for diabetics. Studies have shown that many people with diabetes choose shoes that are too small and that can cause ulceration.

To avoid any complications, select shoes that are wide enough and long enough. To ensure proper fit, consult with a professional who can determine that correct shoe size and fit.

The difficulty is that once diagnosed with neuropathy, an individual my not feel pain in thier feet and that is where the danger lies. They will be unaware that the shoe is too tight.

In addition, the size of the foot changes as we age. Just as we gain and lose weight, so our feet respond in the same fashion. As we are in a constant state of change, so are our feet.

Individuals with diabetic neuropathy do not have the luxury of putting on an old pair of shoes without first having a professional determine whether they still fit well.

For more information or to schedule an appointment, please contact Affiliated Podiatrists, Inc. at:
440-946-5858 or visit our website www.DrRobertRosenstein.com

And remember...."When your feet hurt, you hurt all over!"

Varicose Veins = Swollen Ankles?

Dr. Rosenstein,

      My ankle keeps swelling. Can that have something to do with my varicose veins?


There are actually several causes for swollen ankles- inflammation, or trauma or a thrombosis in the vein around that area. Generally, but not always, swelling in both ankles would indicate other causes that affect the whole body.

It is important to start with a correct diagnosis from your podiatrist. An evaluation would include consideration of varicose veins, or varicose ulceration or pigmentation of the leg.

Treatment might include raising the foot of your bed 9 inches, so that fluid drains away from the foot during the night. When you sit down, you should raise your foot so that it is higher than your backside. Compression hoisery, support socks, stockings or tights can lessen swelling and they should be put on prior to swelling in the morning when you first get up.

If the problem is not relieved and it is due to varicose veins, then surgery to remove the veins may be necessary.

If your ankle is causing you pain and discomfort, by all means, have it diagnosed as soon as possible.

For more information or to schedule an appointment please contact Affiliated Podiatrists, Inc. at:
440-946-5858 or visit our web site www.DrRobertRosenstein.com

And remeber........"When your feet hurt, you hurt all over!"