The Achilles tendon is located in the back of the calf, and its purpose is to connect the heel bone to the calf muscles. While anyone can injure their Achilles tendon, it is said people that frequently participate in sporting activities like basketball or tennis, may be at a higher risk due to constant stopping and sharp turns. When the tendon stretches too far, it can rupture or tear. This can cause considerable pain and discomfort, and daily activities may be difficult to complete. Some of the symptoms that are often associated with this injury can include difficulty in standing on toes, walking up steps, and some patients may notice the back of the ankle is bruised or swollen. It can help to ease the pain by elevating the affected ankle as often as possible, as this may help to reduce swelling. Treatment can include wearing a brace or splint, which may help to stabilize the foot. If you feel you have injured your Achilles tendon, it is suggested that you consult with a podiatrist who can guide you towards the best treatment options.

Achilles tendon injuries need immediate attention to avoid future complications. If you have any concerns, contact the Foot Health Team of Dr. Peter F. Gregory, D.P.M. to 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 at 734-522-7676.  We are located in Livonia, Michigan.  

What Are Skin Cancers of the Feet?

Skin cancer can develop anywhere on the body, including in the lower extremities. Skin cancers of the feet have several features in common. Most are painless, and often there is a history of recurrent cracking, bleeding, or ulceration. Frequently, individuals discover their skin cancer after unrelated ailments near the affected site.

Causes

We often view the sun's harmful rays as the primary cause of skin cancer; the condition is often found on parts of the body that receive the most sun exposure. Skin cancers of the feet, however, are more often related to viruses, exposure to chemicals, chronic inflammation or irritation, or inherited traits. Unfortunately, the skin of the feet is often overlooked during routine medical examinations, and for this reason, it important that the feet are checked regularly for abnormalities that might indicate evolving skin cancer.

Types and Symptoms

Some of the most common cancers of the feet are:

Basal Cell Carcinoma: Basal cell carcinoma frequently is seen on sun-exposed skin surfaces. With feet being significantly less exposed to the sun, it occurs there less often. This form of skin cancer is one of the least aggressive cancers in the body. It will cause local damage but only rarely spreads beyond the skin. Basal cell cancers may appear as pearly white bumps or patches that may ooze or crust and look like an open sore. On the skin of the lower legs and feet, basal cell cancers often resemble non-cancerous skin tumors or benign ulcers. 

Squamous Cell Carcinoma: Squamous cell carcinoma is the most common form of cancer on the skin of the feet. Most types of early squamous cell carcinoma are confined to the skin and do not spread. However, when advanced, some can become more aggressive and spread throughout the body. This form of cancer often begins as a small scaly bump or plaque, which may appear inflamed. Sometimes there is a history of recurrent cracking or bleeding. Occasionally it begins as a hard projecting callus-like lesion. Though squamous cell cancer is painless, it may be itchy. Squamous cell cancer may resemble a plantar wart, a fungal infection, eczema, an ulcer, or other common skin conditions of the foot.

Malignant Melanoma: Malignant melanoma is one of the deadliest skin cancers known. Non-surgical treatments are rarely effective, and many remain experimental. This type of skin cancer must be detected very early to ensure patient survival. Melanomas may occur on the skin of the feet and on occasion beneath a toenail. They are found both on the soles and on the top of the feet. As a melanoma grows and extends deeper into the skin, it becomes more serious and may spread through the body through the lymphatics and blood vessels.

Malignant melanoma has many potential appearances, leading to its nickname, “The Great Masquerader.” This skin cancer commonly begins as a small brown-black spot or bump; however, roughly one third of cases lack brown pigment and thus appear pink or red. These tumors may resemble common moles; however, close inspection will usually demonstrate asymmetry, irregular borders, alterations in color, and/or a diameter greater than 6 mm.  Melanomas may resemble benign moles, blood blisters, ingrown nails, plantar warts, ulcers caused by poor circulation, foreign bodies, or bruises. 

When to Visit a Podiatrist

Podiatrists are uniquely trained as lower extremity specialists to recognize and treat abnormal conditions on the skin of the lower legs and feet. Skin cancers affecting the feet may have a very different appearance from those arising on the rest of the body. For this reason, a podiatrist's knowledge and clinical training is of extreme importance for patients for the early detection of both benign and malignant skin tumors.

Learn the ABCDs of melanoma. If you notice a mole, bump, or patch on the skin that meets any of the following criteria, see a podiatrist immediately:

• Asymmetry - If the lesion is divided in half, the sides don't match.
• Borders - Borders look scalloped, uneven, or ragged.
• Color - There may be more than one color. These colors may have an uneven distribution.
• Diameter – The lesion is wider than a pencil eraser (greater than 6 mm).

To detect other types of skin cancer, look for spontaneous ulcers and non-healing sores, bumps that crack or bleed, nodules with rolled or “donut-shaped” edges, or scaly areas.

Diagnosis and Treatment

Your podiatrist will investigate the possibility of skin cancer both through a clinical examination and with the use of a skin biopsy. A skin biopsy is a simple procedure in which a small sample of the skin lesion is obtained and sent to a specialized laboratory where a skin pathologist will examine the tissue in greater detail. If a lesion is determined to be cancerous, your podiatrist will recommend the best course of treatment for your condition.

Prevention

Prevention of skin cancer on the feet and ankles is similar to any other body part. Limit sun exposure, and make sure to apply appropriate sunscreen when you are outdoors and your feet and ankles are exposed.  If you have any questions or concerns regarding skin cancers on your feet please contact the Foot Health Team of Dr. Peter F. Gregory, D.P.M.  734-522-7676.  We are here to help.

If running is part of your exercise regimen, then you need to understand the importance of a well-fitting running shoe. The right shoe will make the difference between prolonged injury or an enjoyable running experience. The problem lies on the fact that some runners are not informed - they just select the most popular shoes or brands. Not many realize that they are different foot types and shapes, and it's important that they select a shoe that accommodates their foot shape to prevent running injuries.  

Regardless of what foot type you have, there are running shoes that are right for you. With all the pressure one gets from TV ads or what is "popular to wear now", you really need to put the health aspect first. Most likely you will be able to find a show that is right for your foot type and still have style.

When you try on a shoe it should be snug, but not tight, and there should be approximately a 1/2-inch between your longest toe and the front of your running shoe. Shoe Shopping Tip: Shop for your shoes late in the afternoon when your feet are a little more spread. If it is not comfortable when you are in the store, imagine what it will be like when you are out on a run... so make sure you test them well while you're there.
 

Foot infections are risky and potentially life-changing. This is the case because they can lead to amputations. In particular, diabetics who incur foot infections can have severe issues depending on if they are mild, modest or severe.

Diabetes has the potential to make any foot infection turn serious, which can include cellulitis, necrotizing fasciitis, septic arthritis or tendinitis. Foot infections are among the most common and serious complications of diabetes. Diabetics with foot infections have an increased likelihood of requiring hospitalization. Since diabetics have the increased risk of foot ulcerations, infections are the leading influences for amputation. The usual cause of infections in the foot is bacterial in nature.

If a foot infection is formed because of an untreated wound, it will be cultured by a medical professional to determine the exact cause of the infection so that the most effective medication can be prescribed. If the foot has an ulcer, the skin of it will be scraped off for a biopsy.

Consequently, proper care of foot infections involves effective wound management, use of antibiotics and any surgical treatment that may be necessary. It’s also important to prevent the formation of antibiotic-resistant infections by not using too many unnecessary antibiotics. Therefore, antibiotic treatment should last for up to a month or up to 4 months if the infection has spread or become severe and is absolutely essential.

Treatment for this condition involves:

• Proper management of diabetic foot infections through proper medications, drainage, removal of debris/dead tissues and wound care.
• Surgical procedures that involve corrective measures and/or amputation. These procedures are only effective if done so timely.

Proper management of foot infections is paramount for maintaining suitable long-term foot and ankle health.  The Foot Health Team of Dr. Peter F. Gregory, D.P.M. will identify and manage any foot infection you may develop. So, please call our office at 734-522-7676 to schedule an appointment so that we can help your feet beat any infection that may be present or that which may try to infect your foot in the future.

For many people, feet are something that’s beneath their notice, so to speak. Unless the cause of an acute problem, they simply aren’t given much thought. Unfortunately, if you or someone you love has diabetes you can’t afford to ignore these, the least noticed of our physiology. In fact, neglecting foot care in a diabetic can result in wounds, infections, even amputations and death.