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Posts for: November, 2014

November 24, 2014
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Chronic ankle instability is a condition characterized by a recurring “giving way” of the outer side of the ankle. This condition often develops after repeated ankle sprains. Usually the “giving way” occurs while walking or doing other activities, but it can also happen when you’re just standing.

Chronic ankle instability usually develops following an ankle sprain that has not adequately healed or was not rehabilitated completely. When you sprain your ankle, the connective tissues (such as the peroneal tendons) are stretched or torn, and the ability to balance is often affected. Proper rehabilitation is needed to strengthen the muscles around the ankle and “retrain” the tissues within the ankle that affect balance. Repeated ankle sprains often cause – and perpetuate – chronic ankle instability. Having an ankle that gives way increases your chances of spraining your ankle repeatedly. Each subsequent sprain leads to further weakening of the ligaments – resulting in greater instability and the likelihood of developing additional problems in the ankle.

If your ankle feels wobbly or unstable and gives way repeatedly, or if you’ve had recurring ankle sprains, see Dr. Mendoza to have your condition evaluated and treated. Chronic ankle instability that is left untreated leads to continued instability, activity limitations, arthritis, and tendonitis. Dr. Mendoza may recommend physical therapy, bracing, anti-inflammatory medications, and as a last resort surgery to repair or reconstruct the damaged soft tissue.

Click here or call our office at 615-452-8899 to schedule your appointment with Dr. Mendoza!

November 18, 2014
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Melanoma is a cancer that begins in the cells of the skin that produce pigmentation. It spreads to other areas of the body as it grows beneath the surface of the skin. Melanoma that occurs in the foot or ankle often goes unnoticed during its earliest stage, when it would be more easily treated.

Most cases of melanoma are caused by too much exposure to ultraviolet rays from the sun or tanning beds. Anyone can get melanoma, but some factors put a person at greater risk for developing this type of cancer, including:

·         Fair skin, skin that freckles, blond or red hair

·         Blistering sunburns

·         Numerous moles, especially if they appeared at a young age

Melanoma can occur anywhere on the skin, even in areas of the body not exposed to the sun. Melanoma usually looks like a spot on the skin that is predominantly brown, black, or blue – although in some cases it can be red or even white. However, not all areas of discoloration on the skin are melanoma. There are four signs (known as the ABCD’s of melanoma) to look for when self inspecting moles and other spots on the body:

Asymmetry: Melanoma is usually asymmetric, which means one half is different in shape from the other half.

Border: Border irregularity often indicates melanoma. The edge is typically ragged, notched, or blurred.

Color: Melanoma is typically a mix of colors or hues, rather than a single, solid color.

Diameter: Melanoma grows in diameter, whereas moles remain small. A spot that is larger than 5 millimeters (the size of a pencil eraser) is cause for concern.

To diagnose melanoma Dr. Mendoza will ask the patient a few questions, such as: Is the spot new or old? Have you noticed any changes in size or color? If so, how rapidly has this change occurred? He will also examine the spot to determine whether a biopsy is necessary. If a biopsy is performed and it reveals melanoma, Dr. Mendoza will develop a treatment plan with you.

Everyone should practice strategies that can help prevent melanoma – or at least aid in early detection, so that early treatment can be undertaken. Be sure to apply sunscreen on the soles as well as the tops of feet. Inspect all areas of feet daily – including the soles, underneath toenails, and between the toes. If you wear nail polish, remove it occasionally so that you can inspect the skin underneath the toenails.

Remember, early detection is crucial with malignant melanoma. If you see any of the ABCD signs – or if you have discoloration beneath a toenail that is unrelated to trauma – be sure to call our office at 615-452-8899 or click here to schedule your appointment with Dr. Mendoza as soon as possible!

November 11, 2014
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Charcot foot is a sudden softening of the bones in the foot that can occur in people who have significant nerve damage or neuropathy. The bones are weakened enough to fracture, and with continued walking the foot eventually changes shape. The symptoms can appear after a sudden trauma or even a minor repetitive trauma such as a long walk. As the disorder progresses, the arch collapses and the foot takes on a convex shape, giving it a rocker-bottom appearance, and making it very difficult to walk. Charcot foot is a very serious condition that can lead to severe deformity, disability, and even amputation.

Because of its seriousness, it is important that patients with diabetes take preventive measures and seek immediate care if signs or symptoms appear. It is extremely important to follow the treatment plan; failure to do so can lead to the loss of a toe, foot, or even leg. Treatment for Charcot foot consists of: immobilization in the early stages to protect the soft bones so they can repair themselves. Complete non-weight bearing is necessary to keep the foot from further collapsing. Custom shoes and bracing may be prescribed, and surgery may be necessary based on the severity of the deformity and the patient’s physical condition.

The patient can play a vital role in preventing Charcot foot and its complications by following these measures:

·         Diabetic patients should keep blood sugar levels under control to reduce the progress ion of nerve damage in the feet.

·         Get regular check-ups from a foot and ankle surgeon.

·         Check both feet every day!

·         Be careful to avoid injury and overdoing an exercise program

·         Follow the surgeon’s instructions for long-term treatment to prevent recurrences, ulcers, and amputation.

Click here or call our office at 615-452-8899 to schedule your appointment with Dr. Mendoza today!

November 04, 2014
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Hallux rigidus is a disorder of the joint located at the base of the big toe – different than bunions and sesamoiditis. It causes pain and stiffness in the big toe, and with time it gets increasingly harder to bend the toe. Hallux rigidus is actually a form of degenerative arthritis where the cartilage within the joint slowly becomes worn out. Because hallux rigidus is a progressive condition, the toe’s motion decreases as time goes on. In its earlier stage, motion of the big toe is only somewhat limited – at this point it is called “hallux limitus”. As the problem advances, the toe’s range of motion gradually decreases until it potentially becomes stiff – called “hallux rigidus” or a “frozen joint”.

Common causes of hallux rigidus are faulty biomechanics and structural abnormalities of the foot that can lead to osteoarthritis in the big toe joint. For example, those with fallen arches or excessive pronation (rolling in) of the ankles are susceptible to developing hallux rigidus. In some people, hallux rigidus runs in the family and is a result of inheriting a foot type that is prone to developing this condition. In other cases, it is associated with overuse – especially among people engaged in activities or jobs that increase the stress on the big toe, such as workers who often have to stoop or squat. Hallux rigidus can also result from an injury – even from stubbing your toe. Or it may be caused by certain inflammatory diseases, such as rheumatoid arthritis or gout.

Click here or call our office at 615-452-8899 to schedule your appointment with Dr. Mendoza to determine the cause of your hallux rigidus and receive a treatment recommendation!