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TORONTO CHIROPODIST, D.Ch., B.Sc., PODIATRIC MEDICINE

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Posts for: August, 2018

Podiatrist Dr. Howard Osterman says that he sees far fewer patients than he did 15-20 years ago as a result of pedicure acquired infections because salons are much more concerned with hygiene. But there is still a real risk. If your pedicurist slips and cuts your toes, it opens you up to an infection or toe fungus. Pushing back the cuticles opens the gate to bacteria and toe fungus as well. It’s also helpful to have your pedicurist cut your toenails straight across and not cut the corners of the nail.
 
“Just make sure you aren’t being treated with used pumice” — this porous rock used for exfoliating skin can harbor bacteria — “and don’t be afraid to ask questions” about sterilization procedures for all equipment. The gold standard is to clean metal tools in an autoclave, a machine that sterilizes instruments using high-pressure, high-temperature steam. Cleaning tools in liquid disinfectant can kill most germs and viruses if they soak for at least 10 minutes, but that won’t guarantee sterility, the doctor says.
 
Courtesy of Barry Block, editor of PM News.
 
Brought to you by Doctor John A. Hardy, owner of Toronto's foot clinic, Academy Foot and Orthotics Clinic.

 


Late last year, 53-year-old Miguel Hernandez went to the doctor after ulcers started taking over his right foot. Hernandez is diabetic, and the doctor told him that at least part of his foot, if not all of it, would have to be amputated. "I told him, please, try to save it," Hernandez, a restaurant cook, recalled. "I have to work, I have to support my family." The doctor referred Hernandez to Dr. Gabriel Halperin, who runs a podiatry practice out of a narrow sliver of an office tucked between a real estate agency and a Mexican bakery in East Los Angeles.
 
Dr. Gabriel Halperin (photo: Benjamin Brayfield)
 
 
The practice, called New Hope Podiatry, specializes in limb preservation, and on most days every bed and exam room is taken. In January, doctors from New Hope removed two large chunks of infected tissue from his foot. Seven months later, the wounds are still healing, but Hernandez’s foot remains intact. Halperin said that, in almost every case, the limbs of patients who show up at his office can still be saved.
 
Courtesy of Barry Block, editor of PM News.
 
Brought to you by Doctor John A. Hardy, owner of Toronto's foot clinic, Academy Foot and Orthotics Clinic.

 


Bunions can be made worse by the wrong shoe, or by carrying extra weight, or prolonged periods of standing or walking. Dr. James P. Ioli, chief of podiatry at Brigham and Women’s Hospital in Boston, said wearing the correct shoe size is a good first step in preventing bunions. It’s important to make sure that your toes have enough room. Don’t wear shoes that jam the toes together. High heels are also particularly bad because they move the body’s weight forward and change the mechanics of the foot.

 
Even if you think you know your shoe size, Dr. Ioli said, the size of your foot can change over time. In women who have given birth, the foot ligaments often relax, causing the foot to get longer and wider. Unfortunately, there are not really any effective non-surgical options to reduce the size or reverse the development of a bunion, said Dr. Ioli. But non-surgical treatments can reduce the pain or discomfort from a bunion and keep it from worsening.
 
Courtesy of Barry Block, editor of PM News.
 
Brought to you by Doctor John A. Hardy, owner of Toronto's foot clinic, Academy Foot and Orthotics Clinic.

 


The recent trend toward minimalist running shoes or barefoot running can be problematic for those who've been running in supportive shoes for many years, says Dr. Sherri Greene, a New York podiatrist. "Since most people don't train to strengthen their feet, I find many have very weak muscles and tendons. And it's not a good idea if you have biomechanically-challenged feet (e.g. flat feet) or neuropathy."
 
Dr. Sherri Greene
 
 
Greene recommends wearing supportive shoes or, if you're hooked on the idea of barefoot running, train to strengthen your feet where they may tolerate a minimalist shoe.
 
Courtesy of Barry Block, editor of PM News.
 
Brought to you by Doctor John A. Hardy, owner of Toronto's foot clinic, Academy Foot and Orthotics Clinic.

 


Robert F. Weiss, DPM says, "In the absence of long-term studies on children’s running, many debates have taken place. My thinking has always been that running is a sport that everyone can enjoy, if done at the individual’s own level of fitness and ability. There are, of course, overuse problems in children just as there are in adults. It is also important to remember that a child’s thermo-regulatory system is not as well formed or effective as an adult’s. Yet, they seem to have a greater psychological tolerance for heat and have shown to tolerate cold poorly. Therefore, care should be taken when running in extreme weather conditions."

 
"The parent of a young runner should do what he or she can to keep running fun for the child. Try not to push. Let running be something the child chooses to do. Keep it in moderation, and allow the child a way out if he or she so chooses. The danger comes when the pressure to run is placed on him or her by enthusiastic parents, coaches, or peers. That is when the child will run even though it hurts," says Dr. Weiss.
 
Courtesy of Barry Block, editor of PM News.
 
Brought to you by Doctor John A. Hardy, owner of Toronto's foot clinic, Academy Foot and Orthotics Clinic.

 




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