Diabetic Foot Care

Diabetes has many effects on feet, and it is extremely important that any diabetic seek podiatric care. Here at Affiliated Ankle & Foot Care Center, Dr. Cotler has a wealth of experience in assisting diabetic patients with their foot care.

 

Diabetes is a condition that affects many organs and systems in the body. Feet are the first place where effects of diabetes are seen, mainly because they are the furthest extremities from the heart. It is a well-known fact that one of the first systemic conditions that diabetes effects is the circulatory system. Dr. Cotler specializes in disorders of the foot and ankle and therefore is highly trained to examine for abnormalities of the lower extremity.

 

Many times podiatrists are the first doctors to diagnose vascular disease and neuropathy in the lower extremities. Diabetes can cause both of these systemic disorders and by seeing a podiatrist, the feet, which are most affected by diabetes, can be cared for on a regular basis. Often a small problem can be diagnosed and treated at an early stage and helps prevent the condition from progressing to a more serious disorder.

 

If you suffer from diabetes, it is crucial that you ensure foot health by working with a podiatrist. This will truly reduce the likelihood of an infection. Preventative care is the best step you could take if you have diabetes. 

Ganglions

Ganglions are small, fluid-filled swellings of the joint and tendon that are located on the ankle or on top of the foot. They have the appearance of firm or spongy sacs of liquid and their insides consist of a sticky, clear, thick, jelly-like fluid. Typically they grow slowly and can cause severe irritation when they become too large.

 

The exact cause of ganglions is unknown, but some research has shown that they can form when trauma or repeated irritation weakens the joint or tendon lining. If you wear boots or other restrictive footwear, you may be more susceptible to this condition. Research has also shown that those with bone spurs may also find the pressure of the bony growth can also cause ganglions.

A ganglion usually appears as a smooth bump from 1 to 3 centimeters in diameter. It may disappear and reappear, may be soft or firm, and it may change size. In some cases, you might feel pain if the ganglion presses upon a nerve. If the ganglion is attached to a tendon, the affected area might feel weaker.

 

When it comes to treatment, Dr. Cotler will first complete a physical examination to determine the proper diagnosis. Ganglions often are mistaken for tumors, so visiting us at Affiliated Ankle & Foot Care Center will be extremely beneficial. Treatment methods range from pads placed around the ganglion to reduce pressure, fluid removal, icing and surgery. You can contact our podiatry professions to discuss your symptoms, receive a comprehensive diagnosis and discover the right treatment options. 

Heel Pain/Fasciitis

Heel pain has many causes, and depending on the affliction, can be extremely disruptive or even disabling. Heel pain is generally the caused by placing too much stress on the heel bone and the soft tissues that attach to it. The stress may also result from an injury or a bruise caused by walking, running, or jumping on hard surfaces. It can also be caused by wearing poorly constructed footwear or being overweight.

 

If left untreated, heel pain can lead to further heel damage. Common heel conditions include:

• Heel spurs – bony growth on the underside of the heel bone
• Plantar Fasciitis – inflammation of the band of fibrous connective tissue running along the bottom of the foot
• Excessive pronation – normal, flexible motion and flattening of the arch
• Achilles tendinitis – inflammation of the Achilles tendon

Treatment for heel conditions such as plantar fasciitis or Achilles tendinitis is simple. At Affiliated Ankle & Foot Care Center, Dr. Cotler recommends patients participate in activities such as stretching, icing, footwear change and anti-inflammatory medications to help ease heel pain. If you are experiencing heel pain, visit with our Soldotna, AK to learn if you may be suffering from plantar fasciitis. 

Flatfoot

Flatfoot is a deformity in which the arch of the foot collapses, with the entire sole of the foot coming into contact with the ground. In some individuals, the arch simply never develops in one foot or both feet. Tendons attach the heel and foot bones to cause the arch. When the tendons do not pull together properly, there is little or no arch, causing flatfoot.

 

This condition is common in both children and adults and is treatable. Adults often suffer from flat foot that is caused by stretched or torn tendons, broken or dislocated bones, obesity, diabetes and aging. In some cases, those suffering from flat feet will have no problems or symptoms at all, they require no treatment. Many other patients experience the following symptoms:

• Pain along the course of the PT tendon which lies on the inside of the foot and ankle
• Pain that worsens with activity
• Swollen feet
• Back and leg pain

Those suffering from flat foot are often unable to properly support bodyweight properly, causing extreme pressure in the joints in the ankles, knees and hips. At Affiliated Foot and Ankle Care Center, we can provide various treatment options that include stretching exercises, orthotic devices and more. Our competent staff is well versed in the diagnosis and treatment of flatfoot, call (907) 260-3668 today to schedule an appointment!

Achilles Tendonitis

If you are suffering from painful swelling in the back of the foot, just above the heel, you might be experiencing Achilles Tendonitis issues. This condition affects millions of Americans, from athletes to couch potatoes. At Affiliated Ankle and Foot Care Center, we see and treat this condition quite regularly.

 

This condition affects the Achilles tendon, which is the strongest and largest tendon in the body. It also connects the leg to the foot as it stretches from the lower leg to the heel bone. The Achilles tendon is crucial to sustaining normal walking patters as it allows the foot to rise up on the toes.

This condition typically develops gradually as the tendon inflammation and may include one or more of the following three stages:

• Peritenonitis – an inflammatory and fibrous reaction between the tendon and the paratenon (areolar tissue filling the space between a tendon and its sheath). It may occur by itself or in conjunction with tendinosis.
• Tendinosis ­– typically an asymptomatic stage that may result in a nodule, or know to swelling at the back of the leg
• Peritenonitis with tendinosis - this stage may lead to a rupture of the tendon and it is characterized by pain and swelling during and after activity.

Similarly to most medical conditions, Achilles tendonitis is best treated early in its development. If you are experiencing pain and/or swelling in this region, a consultation with Dr. Harry Cotler will give you the best chance for a full recovery. You can schedule an appointment at our Soldotna, AK practice by calling (907) 260-3886 or visit us online at www.hcotler.com to learn more about our practice!

Brachymetatarsia

Brachymetatarsia, also known as “short toe” is a condition where there is a growth disturbance to a bone in the foot, creating a short toe. If more than one of the long bones of the foot is affected, it is known as brachymetapody. A short fourth toe is most common, though it could affect any toe.  The toe itself is usually normal length, but the bone the toe attaches to in the arch (metatarsal bone) is short.  A really short toe can be described as a floating toe.

 

Patients who suffer from brachymetatarsia are often in considerable pain. The toe will sit higher up on the foot and can become irritated in shoes. Weight distribution of the ball of the foot is also altered with short toe, causing pain and pressure calluses. Patients suffering from this condition tend to hide their feet and avoid going barefoot.

 

There are treatment options available for those with pain or embarrassment caused by brachymetatarsia; both surgical and non-surgical options are offered. At Affiliated Ankle and Foot Care Center, we often start with custom orthotics may in order to properly distribute the weight across the foot while in motion. The surgical grafting of bone to lengthen the short toe may also be an option in some cases. Contact us today to learn how we can help you regain a greater sense of balance and a smoother range of motion.

 

Visit us online at www.hcotler.com or call our Soldotna, AK office at (907) 260-3668 to schedule an appointment with Dr. Harry Cotler! 

Running Injuries

Now that the weather is starting to get a little nicer, we thought we’d let you know about some common running injuries and how you can best prevent them this summer. Whether you are a professional athlete or just a weekend warrior, there is always the chance that you could get hurt. The best way to prevent injuries is to prepare, work smart and recover.

Running is a great way to release some endorphins, get outside and get healthy, but if you’re not properly preparing yourself, you could find yourself on a doctor’s table pretty quickly. The most common running-related foot injuries are:

• Shin Splints – pain that occurs in the front or inside of the lower leg along the shin bone. Treatment includes rest, stretching and a slow return to your normal level of activity
• Achilles Tendinitis – this inflammation occurs in the Achilles tendon and causes pain and stiffness in the area of the tendon. Treatment includes rest, cold compress on the afflicted area and calf stretches
• Plantar Fasciitis –inflammation in the plantar fascia tissue that causes a great deal of pain during physical activity. Treatment should include calf stretches, rest and cold compress to the afflicted area
• Blisters – these fluid filled sacks occur due to friction between shoes/socks and skin. If you have blister problems, consider getting new shoes, wearing socks with a double layer and apply petroleum jelly on areas prone to blisters

If you have suffered any running injuries, take a minute to think about how important your feet are to you and your daily life. If you are in pain and your home remedies are not working, schedule an appointment with us at Affiliated Ankle & Foot Care by calling (907) 260-3668. 

Arch Disorders

Arch pain can be a crippling condition that makes even the simplest tasks almost impossible. Arch pain, often referred to as arch strain, is an inflammation and/or burning sensation at the arch of your foot. If you are currently having arch problems, it might be time to come in and get it checked out. At Affiliated Ankle & Foot Care, we take a proactive approach to healing your heal pain so it does not advance to a more painful condition down the road.

 

A factor in the early management of arch pain is receiving an accurate diagnosis from your podiatrist, Dr. Harry Cotler. If the symptoms are mild, Dr. Cotler may prescribe foot orthotics and stretching exercises to help the calf muscles and arch. If your symptoms are more severe, we may use tape to support the arch and restrict movement as well as prescribe an anti-inflammatory medication and possibly recommend the use of custom orthotics. If there is no relief from those treatments, further testing may be necessary to determine whether such conditions as arthritis or a more serious condition might form.

 

Arch pain is most often caused by plantar fasciitis, which can affect the heel, arch, or both. Plantar fasciitis treatment is the same, regardless of the location of foot pain. If you are suffering from fasciitis or even fallen arches, try these home remedies:

• Rest/ice
• Medicate – non-steroidal anti inflammatory
• Shoe adjustments or custom orthotics
• Use a walking boot or brace

If you are experiencing any arch problems and have tried to manage the pain on your own, it might be time to consider visiting us at Affiliated Ankle & Foot Care. Our professional staff is here to get you back to feeling great!

Neuropathic Pain

Neuropathy in the feet causes a variety of side effects, including burning, achiness and redness. This can be caused by diabetes, having dermatitis, Athlete’s feet or overexertion without wearing the proper footwear. Here at our podiatry office, we offer burning and neuropathic pain treatments in the form of diabetic foot care, necessary surgical procedures, treating infections and treating the exact cause of the burning pain. Physical therapy and rehabilitation treatments are highly effective with this type of foot problem.

Patients who experience the following symptoms are encouraged to consider podiatry care for their burning foot pain:

• Diabetes patients with any type of foot pain.


• Burning pain in one or both feet.


• Foot pain severe enough to affect sleep.


• Patients who want to find alternatives for their foot pain.


• Being unsteady while walking.


• Previously having a fall due to the pain in the foot.

Our treatment plans deal with short-term pain relief and long-term solutions. This is why we incorporate physical therapy as part of the treatment for burning and neuropathic pain of the feet.

Call Dr. Harry Cotler at 907-260-3668 (FOOT) to schedule an appointment if you are experiencing burning or neuropathic pain in your feet.

Infections and Ulcerations

Infections and ulcerations are a common foot condition we see in our podiatry office. Whether from diabetes or conditions that make patients prone to infection, our goal is to treat the foot as quickly and painlessly as possible.  

Foot infections and ulcerations tend to be more common in our diabetic patients, as patients with uncontrolled diabetes are prone to ulcers that can lead to infections if they are left untreated. The ulcer occurs when the skin of the foot breaks down and reveals the tissue underneath. Because it is an open sore, it can lead to infection.

To treat infections and ulcerations, Dr. Harry Cotler begins by covering the ulcer with a dressing if it is caught before an infection occurs. It must be cleaned and dressed regularly to avoid infection. Special shoes may also need to be worn and patients are asked to be careful with their foot and avoid strenuous activities that can worsen the condition. If the ulcer is infected, the infected tissue may need to be removed, the pus may need to be drained, and antibiotics are typically prescribed. If you suspect you have an ulcer or infection of the foot, visit our office in Soldotna, AK right away to receive important treatment.

Trauma and Athletic Injuries

Here at the Dr. Harry Cotler podiatry office, we treat feet and ankles for many different types of injuries. Some of them are sores or infections due to diabetes, while others are from medical conditions that cause chronic pain. We also see many patients with trauma and athletic injuries. Treatment depends on the cause of the injury and what type of injury it is.

There are a lot of possible trauma and athletic injuries that can occur both with children and adults, including ankle fractures and sprains, heel pain, dislocations, ligament injuries, plantar fasciitis, muscle strain, stress fractures, shin splints, tendon pathology, turf toe and tendonitis. The feet and ankles are especially at risk during various types of contact sports and athletic activities, including running.

After diagnosing the type of athletic injury, our podiatrist, Dr. Harry Cotler, decides on the best course of treatment. In some cases, a cast or brace is enough to keep a fracture secured until it begins healing, while a support bandage works well for a muscle strain. We also provide x-rays over the healing period to make sure the bones are healing properly and are not shifting.

Patients who experience trauma and athletic injuries are encouraged to visit us in Soldotna, AK for an examination and treatment options.

Tendon and Joint Pain

Tendon and joint pain in the foot is a common complaint of our patients here at the Dr. Harry Cotler podiatry clinic. There are three main areas of the foot where pain and injuries are felt: the toes, the forefoot and the hindfoot.

The most common types of injuries to the feet and ankles have to do with the tendons, ligaments and joints because they go through so much with regular physical activity every day. The tendons of the foot help connect the muscles to the joints and bones, with the Achilles tendon being the largest tendon, stretching from the calf muscle to the heel. Tendons in the foot can tear, causing severe pain for the patient.

The following treatments are recommended for various types of tendon and joint pain in the foot:

1. Apply an ice pack and resting the foot.

2. Take non-steroidal anti-inflammatory medications.

3. Perform stretching exercises of the Achilles tendons.

4. Wrap the foot in bandages or using supportive devices.

5. Perform in-clinic massage and stretching.

6. Undergo surgery in the more severe cases.

If you have pain in your foot or ankle and suspect tendon and joint pain being the cause, call us at 907-260-3668 (FOOT) to make an appointment.

Neuromas

A neuroma is a condition that occurs when a nerve becomes pinched and is extremely painful for individuals suffering from it. Neuromas are caused by stress to the body system.  This can develop from a trauma that damages the nerve, causing it to swell and become inflamed, a biochemical deformity, or from not wearing the right footwear. Many patients who come to see Dr. Harry Cotler in Soldotna, AK are looking for treatment for foot disorders, including neuromas.

Some symptoms of neuromas are pain in the feet between the toes, swelling between the toes, tingling and numbness, and pain in the ball of the foot. Some of our patients describe it as a feeling of walking on a marble. Before seeking treatment from our clinic, we suggest some home remedies like resting your foot, getting more supportive footwear and taking over-the-counter medications. Once patients are able to see us, we provide these treatment options:

1. X-rays of the foot to look for other causes of the pain.

2. Anti-inflammatory medications and cortisone injections.

3. Taping the ball of the foot to reduce pain.

4. Custom-made shoe inserts.

5. Surgical procedures for more severe pain.

Contact our office at Affiliated Ankle and Foot Care at (907) 260-3668 (Foot) if you have questions about neuromas and the treatments we provide.

Reconstructive Foot Surgery

Reconstructive foot surgery is a type of treatment that helps our patients find relief from various types of pain. Patients may be experiencing foot pain from a recent trauma, accident, a congenital abnormality, arthritis, infection, or simply from wearing the wrong footwear that is too narrow for them. With reconstructive foot surgery, Dr. Harry Cotler is able to restore the stability and function in the foot, while relieving the pain and discomfort from these different conditions.

There are different types of reconstructive foot surgery procedures, which vary based on the problem our patient is experiencing. These procedures include a fusing a bone in the foot, removing a tumor, transferring tendon, implanting joints and others. Because of the advanced form of surgical procedures, reconstructive foot surgery procedures are only considered when other treatments have failed. Many of the conservative treatments we provide our patients will work, but other cases are more severe and need reconstructive foot surgery.

Here at Affiliated Ankle and Foot Care, we give our patients surgical options (such as joint surgery for patients with severe arthritis that is keeping them from walking properly) for improving the mobility and function of their feet when other procedures have not worked,. Visit our website at www.hcotler.com to find out more about reconstructive foot surgery.

Corns and Calluses

Corns and calluses are not always extremely painful, but can be aesthetically displeasing and sometimes cause discomfort for patients. We have many patients visit us who desire treatment for the corns or calluses on their feet, which occur when there is a type of friction or pressure from footwear. Corns and calluses can sometimes go away on their own, but in more severe cases, Dr. Harry Cotler provides treatment in Soldotna, AK.

Corns and calluses are both caused from friction and pressure on a specific area of skin. Because of the pressure, the skin on the foot dies and provides a hard surface to protect it. The majority of corns and calluses are the result of pressure from shoes:

• ·         Wearing shoes that are too tight.


• ·         Wearing shoes that are too narrow.


• ·         Loose shoes that cause rubbing and friction.


• ·         Shoes with thin soles, creating pressure on the ball of the foot.


• ·         Wearing shoes without socks.


• ·         Sandals causing friction between the toes.


• ·         Shoes with a seam or stitch rubbing against the foot.

Patients who have diabetes, or other medical conditions that cause bad circulation in the feet, should visit our Affiliated Ankle and Foot Care podiatry office as soon as they notice corns or calluses. Contact us for more information on corns and calluses.

Heel Spurs

Patients who are experiencing a hard calcium deposit under their heel bone may be dealing with heel spurs. For some patients, they are painless and hardly noticeable, but they can be quite painful for others. Some heel spurs protrude a half-inch, which is visible on an X-ray. Patients often have heel spurs along with a condition called plantar fasciitis, which causes inflammation of the connective tissue under the ball of the foot to the heel.

Some people are at a higher risk of getting heel spur, including patients who are overweight, wear improper footwear without arch support, run or jog on hard surfaces or have a walking gait abnormality. Patients who are older, have diabetes or have flat feet are also at risk.

We provide multiple treatment options for patients with heel spurs here at Affiliated Ankle and Foot Care in Soldotna, AK beginning with orthotics that are custom made. Orthotics are custom shoe inserts for different types of shoes. Changing our patient’s footwear may also be required. After orthotics, Dr. Harry Cotler also provides prescription medications like anti-inflammatory medications and cortisone injections. Surgery may also be necessary to reduce or remove the heel spurs, if they are causing or patient severe pain. Visit our website at www.hcotler.com or call us at (907) 260-3668 (Foot) to learn more about heel spurs and the treatment options.

Lower Extremity Vascular Examinations

If you have been experiencing pain or cramping in your legs and hip muscles while walking, it might be due to a condition of the legs and feet called peripheral arterial disease (PAD). Here at Affiliated Ankle and Foot Care, we use lower extremity vascular examinations to look for this and similar conditions. PAD occurs when there is build up on the walls of your arteries that carry blood to your legs, as well as feet. When this occurs, it causes cramping of your legs and hips.

Our vascular examinations use a lower extremity Doppler, photoplethysmography (PPG), and pulse volume (PV) to properly diagnose your lower extremity conditions. It lets us get an accurate diagnosis without having to guess the cause of your pain and discomfort. As part of the examination, our podiatrist, Dr. Harry Cotler, will look at your feet and ankles, including between your toes to see if you have ulcers or scars, at the skin on your feet, your arch and your heels. This physical examination combined with our advanced technology lets us determine the best course of action for treatment.

Call our podiatry office today at (907) 260-3668 (Foot) to schedule an appointment for a lower extremity vascular examination.

3DO Foot Imaging

Foot and ankle issues require modern technology for a proper diagnosis. We use 3DO Foot Imaging here at Affiliated Ankle and Foot Care to accomplish this. While ultrasounds are also performed here in our podiatry office, we believe that the 3DO imaging system helps us get the most accurate diagnosis.  With this technology, we can help you discover optimal treatment options. This technology uses 2D and 3D gait analysis, advanced software, neutral positioning, reliable and consistent data, and quick scans of the foot and ankle.

The following covers what the 3DO Foot Imaging technology provides:

1. 3D plantar surfacing

2.  Pressure analysis

3.  Gait analysis

4.  Mass displacement analysis

5.  Body balance analysis

By choosing our Seldotna, AK podiatry office, you benefit by having the most advanced technology available for foot and ankle care. After using this fantastic machine, we will provide you with an accurate diagnosis and move on to possible treatment options. If surgery is not required, we will not recommend it. Our goal is to provide you with the easiest and less invasive treatments available. Visit our website www.hcotler.com or office today to get started on your treatment.

Comprehensive Foot and Ankle Care

Here at Affiliated Ankle and Foot Care, we provide comprehensive foot and ankle care. Our facilities provide you with the best care available in the Seldotna, AK area. There are many conditions that lead to pain, discomfort, numbness, or tingling of the foot and ankle and we are more than happy to help you find relief.

Services in our podiatry office include surgery on the foot, arches or ankle, reconstruction of flat feet, bracing, 3D imaging, treatment after a sports or personal injury, care of your diabetic feet, and custom-made orthopedics. If you have any of the following conditions, you should come into our office:

• Corns


• Warts


• Toenail conditions


• Calluses


• Hammertoes


• Pediatric foot issues


• Plantar fascia


• Heel pain


• Fractures

Harry Cotler, our podiatrist, is skilled at taking care for all types of foot and ankle problems. Whether you are experiencing pain from a fallen arch, or you recently had an ankle fracture from high school football, we can help you get relief. Treatments include surgical and non-surgical for the least invasive procedure possible. Call us today at (907) 260-3668 (Foot) to schedule a consultation.

Medical and Surgical Treatment of Arch Disorders

Foot pain is often the result of the arch.  This is particularly commonly in patients with fallen arches, otherwise known as flat feet. At Affiliated Ankle and Foot Care, we provide a wide range of medical and surgical treatment of arch disorders, pain, and discomfort. Due to your arches, you may develop another condition called plantar fasciitis, which causes pain and inflammation from the arch to the heel. Our treatment options will help you find from arch-related foot pain.

We provide both surgical and non-surgical treatment options for arch disorders. The following surgeries may be required if medical treatment is not reducing your pain or discomfort:

• Excision to remove spurs


• Lateral column lengthening for creating a natural arch


• Tendon transfer to form an arch by pulling tendons in your foot


• Synovectomy to clean the protective coverings of your foot’s tendons

Arch disorders and other foot conditions cause moderate to severe pain. They may be worse when you are walking or standing on your feet for a long time, but we recommend regular physical activity along with other lifestyle changes. To find out more about treatment options for arch disorders, visit our office in Seldotna, AK.