Children’s Soccer Linked to Ingrown Toenails
Snug cleats, repeated kicking can contribute to a painful problem
(Gastonia, NC – March 2011) Toes and feet can take a beating, especially from sports.
Foot and ankle surgeon Dr. Wagner Santiago and his partners Doctors Dave Kirlin and Ryan Meredith treat many soccer-playing children for ingrown toenails. Santiago blames improper toenail trimming, snug soccer cleats and repetitive kicking for creating this painful problem.
“Many kids wear hand-me-down cleats that don’t fit,” says Santiago. “Older children like tighter cleats. They believe it gives them a better feel for the ball and the field.”
Santiago, whose office is in Gastonia, is board certified by the American Board of Podiatric Surgery. He says there are steps soccer moms and dads can take to prevent their children from suffering a painful ingrown toenail. First, teach children how to trim their toenails properly. Trim toenails in a fairly straight line, and don’t cut them too short. Second, make sure cleats fit properly.
“A child’s shoe size can change within a single soccer season,” Santiago reminds parents.
If a child develops a painful ingrown toenail, soaking their foot in room-temperature water and gently massaging the side of the nail fold can reduce the inflammation. But Santiago warns parents against home treatments, which can be dangerous. The American College of Foot and Ankle Surgeons lists myths about ingrown toenail home treatments on its Web site, FootHealthFacts.org.
“If your son’s or daughter’s ingrown toenails show signs of infection, it’s definitely time to seek medical care,” says Santiago.
A foot and ankle surgeon like Santiago can remove a child’s ingrown toenail, and prevent it from returning, with a simple, 10-minute surgical procedure. During the short procedure, the doctor numbs the toe and removes the ingrown portion of the nail. Various techniques can permanently remove part of a nail’s root too, preventing it from growing back.
“Most children experience very little pain afterwards,” says Santiago, “and can resume normal activity the next day.”
Other soccer-related injuries Santiago often treats include ankle sprains, foots sprains and broken bones.
For more information on ingrown toenails and other pediatric foot problems, contact Dr. Santiago’s office at (704) 964-6466, or visit the Gaston Foot & Ankle Associates website at www.gastonfoot.com
Gaston Foot & Ankle Associates Opens Center For Wound Healing
Gaston Foot & Ankle Associates has been treating Gaston County patients for over 26 years and is adding wound care to the list of services provided. Dr. David Kirlin, Dr. Ryan Meredith, and Dr. Wagner Santiago are experienced wound care specialists who will now offer comprehensive wound care for chronic, complex and complicated wounds in their conveniently located office in Gastonia.
Treatment is available for a variety of foot wounds such as severe infections, diabetic foot ulcers, serious cuts, burns, and snake or spider bites. Services available include in-office debridement of wounds, skin grafts, Peripheral Arterial Disease (PAD) testing, off-loading devices, custom-molded and fitted shoes, custom-molded shoe inserts and reconstruction.
The primary goals of the Center for Wound Healing at Gaston Foot & Ankle Associates are:
- Prevention: encouraging at-risk patients with wounds to have regular visits with a wound specialist
- Healing: provision of coordinated, comprehensive care to heal wounds
- Maintenance: education of patients on day-to-day care of wounds and the importance of regular follow-up visits
Gaston Foot & Ankle Associates uses a multidisciplinary approach which includes a thorough diagnostic examination to identify the type of wound and to determine the underlying complications prolonging the healing process. Once examined, a personalized treatment plan is developed to accommodate each patient’s individual needs.
“We are pleased to offer an affordable option for patients by providing these services all in one place with no extra fees,” said Wagner Santiago, DPM. “Our objective is to save limbs and prevent unnecessary amputations.”
Along with their wound care services, Gaston Foot & Ankle Associates also has treats general podiatric conditions such as Achilles tendons, ankle sprains, athlete’s foot, bunions, corns, calluses, sports injuries, diabetic foot complications, fungus toenails, hammertoes, foot and ankle fractures, flat feet and fallen arches.
For more information about the Center for Wound Healing and Gaston Foot & Ankle Associates, visit www.gastonfoot.com or call the office at (704) 964-6466
Hikers and Hunters: Long, Vigorous Hikes Take Toll on Feet, Ankles
(Gastonia, NC) –As brightly colored leaves dazzle the fall landscape, hikers and hunters nationwide will migrate to mountains, woods and fields, but many, unfortunately, are ill prepared for the beating their feet will take, warns a local foot and ankle surgeon.
“Hikers, hunters and others who love the outdoors often don’t realize how strenuous it can be to withstand constant, vigorous walking on uneven terrain,” said Ryan Meredith, DPM, a member of the American College of Foot and Ankle Surgeons (ACFAS) located in Gastonia, NC. “Lax physical conditioning and inappropriate footwear bring scores of outdoor enthusiasts into our office each fall for treatment of foot and ankle problems such as chronic heel pain, ankle sprains, Achilles tendonitis, fungal infections and severe blisters.”
“Walking up and down steep hillsides and tramping through wet, slippery fields and wooded areas puts stress on the muscles and tendons in the feet and ankles, especially if you haven’t conditioned properly before hitting the trail,” said Meredith. “Also, many don’t realize that cross-training athletic shoes aren’t the best choice for extended hiking and hunting. Had some of my patients worn sturdy, well constructed hiking boots, they wouldn’t have suffered sprained ankles or strained Achilles tendons.”
Meredith advises hikers and hunters to make the investment in top-quality hiking boots. He said strong, well insulated and moisture-proof boots with steel or graphite shanks offer excellent ankle and foot support that helps lessen stress and muscle fatigue to reduce injury risk. “The supportive shank decreases strain on the arch by allowing the boot to distribute impact as the foot moves forward. So if a boot bends in the middle, don’t buy it.”
In wet and cold weather, wearing the right socks can help prevent blisters, fungal infections and frostbite. Meredith, along with partners Dave Kirlin, DPM and Wagner Santiago, DPM, recommends synthetic socks as the first layer to keep the feet dry and reduce blister-causing friction. For the second layer, wool socks add warmth, absorb moisture away from the skin, and help make the hiking boot more comfortable. “Wool lets moisture evaporate more readily than cotton, so fewer blisters develop,” he added.
What happens if your feet or ankles hurt during a hike or hunt? Meredith said pain usually occurs from overuse, even from just walking. “If you’re not accustomed to walking on sloped or uneven ground, your legs and feet will get tired and cause muscles and tendons to ache,” he explained. “To avoid a serious injury, such as a severe ankle sprain or an Achilles tendon rupture, rest for awhile if you start hurting.”
According to the ACFAS consumer website, FootHealthFacts.org, pain is a warning sign that something is wrong. “Serious injury risk escalates significantly if you continue hiking in pain.” He likened hiking to skiing, in that beginners should take on less difficult trails until they become better conditioned and more confident.
Evaluation by a foot and ankle surgeon is recommended if there is persistent pain following a hiking or hunting outing. “I’m most concerned about ankle instability and strained Achilles tendons. Inattention to these problems at their early stages may lead to a serious injury that will keep you off the trails for a long time,” Meredith said.
Hikers and hunters seeking further information about ankle sprains, Achilles tendon injuries and other foot and ankle problems may contact Dr. Meredith at Gaston Foot & Ankle Associates’ office at (704) 964-6466 or visit the practice’s website at www.gastonfoot.com.
Flip-Flops Tied to Surge in Teenage Heel Pain
(Gastonia, NC) Many of us are welcoming the warmer weather sporting flip-flop sandals, however, their popularity among teens and young adults is responsible for a growing epidemic of heel pain in this population, according to Wagner Santiago, DPM, FACFAS, a Fellow of the American College of Foot and Ankle Surgeons.
“We’re seeing more heel pain than ever in patients 15 to 25 years old, a group that usually doesn’t have this problem,” says Santiago, who has an office in Gastonia with partners Dave Kirlin, DPM and Ryan Meredith, DPM. “A major contributor is wearing flip-flop sandals with paper-thin soles everyday to school. Flip-flops have no arch support and can accentuate any abnormal biomechanics
in foot motion, and this eventually brings pain and inflammation.”
Santiago recommends wearing sandals with reasonably strong soles and arch support.
“Especially for girls and young women, thicker soled sandals with supportive arches might not be considered stylish, but if you want to wear sandals most of the time, you’ll avoid heel pain if you choose sturdier, perhaps less fashionable styles,” he says.
It is estimated that 15 percent of all adult foot complaints involve plantar fasciitis, the type of heel pain caused by chronic inflammation of the connective tissue extending from the heel bone to the toes. Being overweight and wearing inappropriate footwear are common contributing factors.
The pain is most noticeable after getting out of bed in the morning, and it tends to decrease after a few minutes and returns during the day as time on the feet increases. Not all heel pain, however, is caused by plantar fasciitis. It also can occur from inflammation of the Achilles tendon, bursitis, arthritis, gout, stress fractures, or irritation of one or more of the nerves in the region. Therefore, diagnosis by a foot and ankle surgeon to rule out other causes is advised.
Initial treatment options for heel pain caused by plantar fasciitis should include anti-inflammatory medications, padding and strapping of the foot and physical therapy. Patients also should stretch their calf muscles regularly, avoid wearing flat shoes and walking barefoot, use over-the-counter arch supports and heel cushions, and limit the frequency of extended physical activities.
Most patients with plantar fasciitis respond to non-surgical treatment within six weeks. However, surgery is sometimes necessary to relieve severe, persistent pain.
For further information about heel pain, contact Dr. Santiago at (704) 964-6466 or visit practice website at www.gastonfoot.com. You may also visit the ACFAS consumer Web site, www.FootHealthFacts.org.
Spring is Ankle Sprain Season in Gaston Area
Spring is Ankle Sprain Season in Gaston Area
(Gastonia, NC) Spring is sports season for many amateur athletes and weekend warriors in the Gaston area. It’s also ankle sprain season for one area foot and ankle surgeon.
Dave Kirlin, DPM, FACFAS, a foot and ankle surgeon with an office in Gastonia says ankle sprains are one of the most common sports injuries he treats this time of year.
“As people emerge from their winter hibernation and start to get active again, they can injure their ankles playing sports such as basketball, baseball, tennis and soccer,” he says.
Anyone who injures an ankle requires prompt medical treatment, whether it’s their first sprain or their fifth. Rest, ice, compression and elevation (R.I.C.E.) can reduce swelling and pain until the ankle can be evaluated and treated by a foot and ankle surgeon. A sprain may not always be a sprain; the ankle could be fractured.
Kirlin, who practices at Gaston Foot & Ankle Associates with partners Ryan Meredith, DPM and Wagner Santiago, DPM, notes that many athletes develop chronic ankle instability from repeated ankle sprains, causing their ankle to frequently “give way.” In some cases these players may require surgery. Proper rehabilitation of an ankle sprain reduces the likelihood of developing chronic ankle instability.
Kirlin shares three spring ankle sprain prevention tips from FootHealthFacts.org:
- Perform warm-up stretches and exercises before playing sports.
- Wear the right shoes for the sport. For example, don’t wear running shoes for sports that involve a lot of side-to-side movement, such as tennis and basketball.
- Wear an ankle brace if you’re recovering from an injury or have repeatedly sprained your ankle.
Dr. Kirlin, as well as Drs. Meredith and Santiago, are members of the American College of Foot and Ankle Surgeons (ACFAS) and all are board certified in foot and ankle surgery. Kirlin has been practicing in Gastonia since 1984.
For more information about ankle fractures and sprains or other foot and ankle problems, contact Gaston Foot & Ankle Associates’ office at (704) 964-6466 or visit FootHealthFacts.org.
Fix Feet for Weight Loss Success
Fix Feet for Weight Loss Success
(Gastonia, NC) Many of the estimated 70 million obese Americans are trapped in a life-threatening vicious cycle: Obesity aggravates foot problems, like heel pain and flat feet; sore feet make it hard to exercise and lose weight; and without exercise, obesity worsens and exacerbates progression of diabetes, heart disease and other serious health threats. Today, a Gaston County foot and ankle surgeon urged obese adults to seek immediate treatment for chronic, activity-limiting foot and ankle problems to foster compliance with physician-directed exercise programs.
“It’s unfortunate obese adults get caught up in the vicious cycle of avoiding physical activity due to foot or ankle pain, thereby permitting cardiovascular disease and other life-threatening conditions to worsen as a result,” says Ryan Meredith, DPM, a member of the American College of Foot and Ankle Surgeons (ACFAS ). “For example, in many cases, chronic heel pain occurs from carrying too much weight. Left untreated, it becomes an impediment to physical activity and meaningful weight loss.”
Meredith, who practices at Gaston Foot & Ankle Associates with partners Dave Kirlin, DPM and Wagner Santiago, DPM, says there’s no reason foot or ankle pain should stop obese patients from exercising. The first step toward breaking that vicious cycle is an evaluation by a foot and ankle surgeon.
According to the ACFAS consumer Web site, FootHealthFacts.org, many causes of foot pain can be relieved without surgery through stretching exercises, orthotics and athletic shoes with good shock absorption and support. If a bunion, heel pain or other condition requires surgery, patients can participate during their recovery in non-weight-bearing activities, such as riding a stationary bike, swimming or weight training.
For those moderately to severely overweight, Meredith says a thorough physical examination is mandatory before beginning an exercise program.
“Once cleared by your physician to begin exercising, don’t try to do too much too soon. Follow a gradual routine until your body adjusts to the stress of regular physical activity,” he says. “For example, I counsel overweight patients to avoid working out on treadmills or elliptical machines to minimize pounding and stress on their joints.”
Shedding excess pounds helps diabetic patients control their disease, but Meredith notes many who experience foot ulcerations and vascular problems caused by diabetes might think they shouldn’t exercise.
“Every diabetes patient needs regular foot exams to check for possible sore spots and assess nerve sensation,” says Meredith. “And with proper diabetic foot care and the right footwear, most patients can follow an exercise regimen that is safe and appropriate for them.”
For more information about ankle fractures and sprains or other foot and ankle problems, contact Gaston Foot & Ankle Associates’ office at (704) 964-6466, or go to FootHealthFacts.org.
For Many, Winter is Fall Season
For many, winter is fall season
Icy conditions cause falls and broken ankles
(Gastonia, NC) With the hectic pace of the holidays, serious injuries from ice-related falls inevitably occur. A Gaston County foot and ankle surgeon says falls on icy surfaces are a major cause of ankle sprains and fractures, and it’s critical to seek prompt treatment to prevent further damage that can prolong recovery.
David Kirlin, DPM, AACFAS says the ankle joint is vulnerable to serious injury from hard falls on ice.
“Ice accelerates the fall and often causes more severe trauma because the foot can go in any direction after slipping,” he says.
Kirlin is a member of the American College of Foot and Ankle Surgeons (ACFAS) with an office in Gastonia, NC. He adds that in cases of less severe fractures and sprains, it’s possible to walk and mistakenly believe the injury doesn’t require medical treatment.
“Never assume the ability to walk means your ankle isn’t broken or badly sprained,” he says. “Putting weight on the injured joint can worsen the problem and lead to chronic instability, joint pain and arthritis later in life.”
Some people may fracture and sprain an ankle at the same time, and a bad sprain can mask the fracture.
“It’s best to have an injured ankle evaluated as soon as possible for proper diagnosis and treatment,” says Kirlin. “If you can’t see a foot and ankle surgeon or visit the emergency room right away, follow the RICE technique – Rest, Ice, Compression and Elevation – until medical care is available.”
According to the ACFAS consumer website, FootHealthFacts.org, even though symptoms of ankle sprains and fractures are similar, fractures are associated with:
- Pain at the site of the fracture that can extend from the foot to the knee
- Significant swelling
- Blisters over the fracture site
- Bruising soon after the injury
- Bone protruding through the skin—a compound fracture, which requires immediate attention!
Most ankle fractures and some sprains are treated by immobilizing the joint in a cast or splint to foster union and healing. However, surgery may be needed to repair fractures with significant malalignment to unite bone fragments and realign them properly.
Dr. Kirlin said newly designed surgical plates and screws allow repair of these injuries with less surgical trauma.
“With newer bone-fixation methods, there are smaller incisions to minimize tissue damage and bleeding and accelerate the healing process,” he says.
Kirlin recommends scheduling an appointment with (HIS OR HER) office if you have injured your ankle in any way.
“If you fall on an icy spot and hurt your ankle, the best advice is to seek medical attention immediately,” he says. “This aids in early diagnosis and proper treatment of the ankle injury and reduces the risk of further damage.”
For further information about ankle fractures and sprains or other foot and ankle problems, contact Gaston Foot & Ankle Associates, PA at (704) 964-6466.
Soccer Season: Prime Time for Foot & Ankle Injuries
Soccer season: Prime time for foot, ankle injuries
(Gastonia, NC) — Soccer season is in full swing and a local foot and ankle surgeon strongly urges parents and coaches to think twice before coaxing young, injury-prone soccer players to “play through” foot and ankle pain.
“Starting and stopping and moving side to side on cleats that are little more than moccasins with spikes – that’s a recipe for foot and ankle sprains and worse,” cautions Wagner Santiago, DPM, who along with Dave Kirlin, DPM and Ryan Meredith, DPM, has an office in Gastonia.
“Kids will play with lingering, nagging heel pain that, upon testing, turns out to be a stress fracture that neither they, their parents, nor their coaches were aware of,” he said. “By playing with pain, they can’t give their team 100 percent and they make their injuries worse, which prolongs their time out of soccer.”
Santiago said he has actually had to show parents x-rays of fractures before they’ll take their kids out of the game. “And stress fractures can be subtle – they don’t always show up on initial x-rays.”
Symptoms of stress fractures include pain during normal activity and when touching the area, and swelling without bruising. Treatment usually involves rest and sometimes casting. Some stress fractures heal poorly and often require surgery, such as a break in the elongated bone near the little toe, known as a Jones fracture.
“Soccer is a very popular sport in our community, but the constant running associated with it places excessive stress on a developing foot,” Santiago said. He added that pain from overuse usually stems from inflammation, such as around the growth plate of the heel bone, more so than a stress fracture. “Their growth plates are still open and bones are still growing and maturing – until they’re about 13 to 16. Rest and, in some cases, immobilization of the foot should relieve that inflammation,” Santiago said.
Other types of overuse injuries are Achilles tendonitis and plantar fasciitis (heel pain caused by inflammation of the tissue extending from the heel to the toes).
Quick, out-of-nowhere ankle sprains are also common to soccer. “Ankle sprains should be evaluated by a physician to assess the extent of the injury,” said Santiago. “If the ankle stays swollen for days and is painful to walk or even stand on, it could be a fracture.”
Collisions between soccer players take their toll on toes. “When two feet are coming at the ball simultaneously, that ball becomes like a cement block and goes nowhere. The weakest point in that transaction is usually the foot, with broken toes the outcome,” he explained. “The toes swell up so much the player can’t get a shoe on, which is a good sign for young athletes and their parents: If they are having trouble just getting a shoe on, they shouldn’t play.”
Dr. Santiago, as well as Doctors Kirlin and Meredith, are members of the American College of Foot and Ankle Surgeons (ACFAS) and all are board certified in foot and ankle surgery. Santiago has been practicing in Gastonia since 1999. He can be contacted at (704) 964-6466.
For further information about various foot conditions, contact Gaston Foot & Ankle Associates, PA., in Gastonia at (704) 964-6466 or visit www.gastonfoot.com.
