Calluses

Most of us can remember running around barefoot when we were young. Shoes seemed like such a hindrance! As we get older though, shoes are a necessity for overall health and mobility. And while good fitting shoes are important, many foot maladies are often caused by boney prominences consistent with underlying foot deformities.  These deformities along with thinning skin layers can increase the risk and frequency of calluses.

What Are Calluses And What Causes Them?

Calluses are thick, hardened layers of skin that develop when the skin tries to protect itself against friction and pressure. Your skin will develop a thick rough patch first and then become a hardened bump which can vary in size. It may become tender or painful to touch and your skin may be flaky or dry.

Underlying foot deformities such as hammertoes, bunions, or plantarflexed metatarsals can increase the risk of developing calluses. When you have an underlying problem, simply scraping the callus away doesn’t solve the problem. The callus will return because of the constant pressure and friction associated with the deformity. Also, as we age, our skin can become thinner. Diabetes or other health conditions can also cause poor blood flow to your feet and put you at greater risk for calluses.

Calluses most often happen on the feet, but they can also occur on the hands, elbows, or knees. Most health problems don’t have any advantages. Athletes will tell you that calluses do protect and make their feet less sensitive during sports. If you still go barefoot a lot, you have an even greater chance of developing calluses because of the constant bare contact with the ground and the weight you put on your feet (1.5 times your body weight when walking, 7.5 times your body weight when running).

Home Treatment Options

Once you get a callus, there are many at-home treatment options available, including:

• Keeping your feet clean and using a scrub brush to get rid of any excess skin

• Use a moisturizer designed for feet

• Use a pumice stone or a file for your feet to remove harder skin deposits

• Wear socks that fit well

• Use toe separators, felt pads and non-medicated pads or bandages over areas that rub

• Wear properly fitted footwear

• 
  

It cannot be overstated that wearing ill-fitting shoes when you have underlying foot deformities will cause and exacerbate the formation of calluses and other foot maladies. Shoes that are too tight or too loose, high heels and even seams inside your shoe can cause rubbing and friction leading to foot problems.

In Office Treatment

It’s important that you not try to treat a callus if you have diabetes or other arterial disease. For patients without diabetes, most calluses are unsightly and can lead to a lot of discomfort, but by eliminating the source of friction that causes the callus, the callus can be treated. Often, patients can come in to the office and have their callus debrided (or removed) every six weeks to bring relief.  Custom made orthotics with customized depressions or cut outs can redistribute pressure on the feet and can also provide relief, and in-office acid treatments may also be a consideration if patients do not have health issues that make this type of therapy too risky.

Please call Dr. Sara Shirazi if you would like further assessment of your calluses and foot/ankle pain. 626-517-0022.

Shin Splints

Many of us remember shin splints from our childhood after a day spent in the park, playing tennis on asphalt courts with thin soled rubber tennis shoes or after running for hours through the neighborhood with our friends. Once we got home, our shins were on fire and we didn’t know why. As we got older, we were more careful before physical activities, taking time to stretch before we exercised. Yet, shin splints still occur and are one of the most common complaints we hear from our patients.

What Causes Shin Splints?

Also known as Medial Tibial Stress Syndrome, shin splints are a common injury affecting athletes and runners. Shin splints are characterized by pain in the lower region of the leg between the knee and ankle. Or in the middle to lower portion of the lateral part of the tibia, the larger of the two bones of the lower leg. They are caused by several overlapping factors such as weak core muscles, running uphill, downhill or on uneven terrain or on hard surfaces. If your gait is off, shin splints can occur when the front of the shin gets overstressed and overused from lifting the toes during walking or running.

Improper footwear and worn-out shoes can also cause shin splints. As you repeatedly hit a hard surface without the proper support, the stress on the bones cannot absorb the impact forces as the foot repeatedly hits the ground. Your tibia will actually bend or bow from the pressure causing shin splints.

Prevention

To prevent shin splints, it’s important to do conditioning before you start any new activities. Training is essential, and you will need to strengthen the larger muscle groups like hips and knees. Yet you must also be flexible in the opposing muscle groups. Warm up exercises are crucial as well. Exercises such as the runners stretch, heel/toe raises, and regular squats will help ward off shin splints. As stated before, we can’t stress enough the importance of the proper footwear.

If you get shin splints, you will develop a recurring dull or razor-like ache along the inner part of the tibia or shin. This pain will occur during all exercise or physical activity and touching the sore spot can aggravate the pain. You might notice tenderness, soreness or pain along the inner side of your shinbone and mild swelling. At first, the pain might stop when you stop exercising. Eventually, however, the pain can be continuous and might progress to a stress reaction or stress fracture if not treated.

Treatment Options

It’s important to treat shin splints immediately. Typical home treatments include rest, ice, and strengthening exercises before you return to any strenuous activities. I cannot stress proper footwear enough. Pre-fabricated or Custom Insoles may be recommended if your arches collapse or flatten when you stand. If you don’t get better, the next step is physical therapy sessions where you will do strengthening exercises to improve foot strike and body mechanics.

We also recommend foam rolls to loosen the tight fascia (the material that wraps most of our muscles) and manual massage. Kinesio taping is another successful way to treat shin splints. The Kinesio tape such as Rocktape is used by physical therapists to change muscle tone, move lymphatic fluids, correct movement patterns, and improve posture. When applied correctly, it lifts the skin to create a small space between the muscle and dermis layers. That space takes the pressure off swelling or injured muscles, allows smooth muscle movement and makes space for drainage and blood flow.

Please feel free to make an appointment with our specialist, Dr. Sara Shirazi, at 626-517-0022.

PinPointe Laser Fungus Nail Treatment FAQs

Frequently Asked Questions

How does it work?

The PinPointe FootLaser kills the fungus that lives in and under the toenail. The laser light passes through the toenail without causing damage to the nail or the surrounding skin. At the time of the procedure, the toenail will not become instantly clear - it takes time to grow out.

What can your patients expect?

They can expect a consultation with you explaining the procedure to be performed and any follow-up visits you prescribe.

Can the patient expect more than one treatment?

One treatment kills the fungus for most patients. You will determine if the patient needs follow-up care.

Is the procedure painful?

Most patients feel no pain. Some may feel a warming sensation and very few feel a pinprick.

Is there a recovery period? No; just walk in and walk out.

How long does the procedure take?

The Footlaser procedure takes less than 30 minutes.

Will the fungus grow back?

The fungus is killed after one treatment, and typically you can recommend care techniques to reduce a recurrence of the infection. There is a chance of reinfection because the fungus is present everywhere in the environment.

When can your patient paint their nails or have a pedicure?

They can apply polish immediately after the treatment. It is important to inform the patient that they should remove all nail polish and nail decorations the day before their treatment.

What kind of payments can I accept for the procedure?

Credit cards, cash, money orders can be accepted. The patient may also use their Medical IRA, Health Savings or Flexible Spending Accounts.

Can the procedure be covered by their insurance?

If they have a Health Savings Account or Medical IRA, 100% of cost can be covered. However, in most situations, this procedure is considered aesthetic, and therefore health insurance plans do not provide coverage.

How long have you been doing this?

Clinical studies began in November 2007 demonstrating over an 88% success rate.

Is it FDA cleared?

Yes, it is cleared by the FDA.

Who developed this laser procedure?

Leading scientists and medical professionals working together for 20 years with funding provided by the National Institutes of Health developed the technology in the patented PinPointe FootLaser.