Ankle Arthritis

Ankle Arthritis

Arthritis means pain within a joint and therefore it is a very broad term which can refer to a myriad of conditions. To date there is no cure for arthritis but there are several viable treatments available and people suffering with the condition can effectively manage their pain to live normally.

With regard to the foot and ankle, there are three types of Arthritis that can effect the area. They are Osteoarthritis, Rheumatoid Arthritis and Post-Traumatic Arthritis.

Osteoarthritis is a degenerative arthritis and usually occurs in middle age. The smooth and gliding surface that cover the ends of bones become worn down and frayed. Inflammation, swelling and joint point can occur. Osteoarthritis is progressive and worsens over time.

Rheumatoid Arthritis is different than Osteoarthritis because it does not follow a predictable pattern within joints. Rheumatoid Arthritis is when a persons own immune system destroys the cartilage or smooth surfaces that cover the ends of the bone.

Post-Traumatic Arthritis develops following an injury. This type of arthritis is more similar to Osteoarthritis because it can progress slowly after an injury and may even take years to develop.

Each type of arthritis effecting the ankle and foot has different causes. Osteoarthritis develops because the cartilage loses the ability to heal itself over time. This is why it tends to appear as we age. However, genetics and obesity have been shown to be related to the development of osteoarthritis.

There is no known cause for Rheumatoid Arthritis but genetic risk factors show that certain people are more susceptible to the disease. It is suspected that something triggers the immune system to produce the chemical substances that appear in the joints and lead to the condition.

Post-Traumatic Arthritis is is a bit more obvious. It can be caused as a result of fractures and dislocations. These traumas make it more likely for arthritic conditions to occur.

Ankle Arthritis is commonly found in the tibiotalar joint where the shin bone connects with the talus bone in the foot. Also in the three joints in the rear of the foot called the subtalar joint, the talonavicular joint, and the calcaneocuboid joint.

Sufferers of Ankle Arthritis may feel pain or tenderness, stiffness, lack of motion and swelling.  There are several treatments available to help alleviate the symptoms. Among them are pain relievers and/or anti-inflammatory medications, custom foot orthotics and or arch supports, custom made shoes, ankle orthoses, physical therapy and exercise.

Surgical Options are also available and careful decisions should be made with a physician. Recovery time may be arduous and lengthy but in most cases today’s procedures will can dramatically improve the condition.

Achilles Tendonitis

Achilles Tendonitis

The largest tendon in the human body is the Achilles tendon and it is designed to handle over 1,000 pounds of force. The Achilles tendon is also the most often ruptured or injured tendon. Achilles tendonitis is an inflammation of the tendon resulting from overuse.

Achilles tendonitis can flare up for several reasons including increasing running distances or speed too quickly, attacking hills too aggressively during training, returning to heavy activity too soon after extended periods of rest, and lack of flexibility in the calf muscles. The condition can also appear after sudden calf muscle contraction during activity.

People experiencing Achilles tendonitis may feel dull pain after exercise that increasingly worsens over time. There may be severe pain along the tendon during or following exercise. Sufferers may feel tenderness in the morning in the lower calf or stiffness that will loosen as the area warms up with activity.

There are several treatments for Achilles tendonitis and they depend on the severity of the condition. Rest is the most immediate treatment but anti-inflammatory medication, stretching, message and ultrasound treatments prove helpful. The use of orthoses, more specifically, custom foot orthotics can dramatically improve the condition and prevent future flare ups.

Of course surgery to heal Achilles tendonitis is an option but should be considered as a treatment of last resort. Surgery will reduce friction between the tendon and its covering sheath which may have built up thick tissue. Also during surgery any tears can be repaired. Recovering from such procedures can be slow and will require rehabilitation to strengthen the area and prevent new injury.

Prevention is always the best medicine. It is very important to use the right shoes which will provide cushion and support during activity. A prescribed custom foot orthotic will change the alignment of misaligned heel bone and greatly reduce the chances of of experiencing Achilles tendonitis. A solid routine of warm up, stretch and cool down is always recommended .

Heel Pain? Arch Pain?

Heel spurs are one of more common problems faced by Podiatric Physicians.  A heel spur is a point of excess bone growth on the bottom of the heel.  Heel spurs are visible by x-rays.  The spur formation usually starts at the heel bone and extends towards the toes.

An even more common problem that is faced by Podiatric Physicians is Plantar Fasciitis.  This common heel problem is caused by a partial tearing of the plantar fascia (a dense fibrous connective tissue that connects the heel to the toes) usually at the attachment of the fascia to the heel bone.  This partial tear can result in a heel spur, fasciitis, or both.

The most frequent cause of heel pain is an abnormal motion of the foot called pronation.  Normally while walking your foot will strike the ground on the heel, then roll forward toward your toes and inward to the arch.  Your arch should only dip slightly during this motion.  If your heel is rotating outwards too much and your arch is lowering too much then you have excessive pronation.  The excess pronation leads to the arch of your foot stretching excessively.  It is this extra stretch in the arch that causes the partial tearing of the plantar fascia and the possibility of spur formation.

Other factors that may contribute to plantar fasciitis and heel spurs include a sudden increase in daily activity, increase in weight, or a change in shoes.  Dramatic increases in training intensity or duration may cause plantar fasciitis.  Shoes that are too flexible in the middle of the arch or shoes that do not bend in the correct location will also increase the amount of tension on the plantar fascia, as will an increase in weight.  And it is this increase in tension that leads to the partial tearing of the plantar fascia.

Plantar fasciitis is usually controlled with conservative treatments.  About 90% or more of the patients with plantar fasciitis will be controlled with conservative treatments.  Conservative treatments consist of: strapping of the feet, combined with a physical therapy program, and anti-inflammatory.  One of the main things a patient can do is stretching of the calf muscles and icing to the painful areas on the heels.  If the patient improves with the temporary strapping, then the patient would most likely also benefit from an arch support.  There are many types of arch supports on the market today.  The best arch support is a custom made orthotic which will control the excessive pronation and also support the arch taking the tension off the plantar fascia.The orthotics can then worn in a variety of shoes.

If the patients continue to have pain a physician could choose to do injection therapy, which consist of injecting a small amount of cortisone into the painful area trying to decrease the amount of inflammation present.  The patient could receive several injections while still performing the conservative treatment also over a period of several weeks or months.

If the pain still continues for a time period of 6 months or more, despite treatment, the patient may be choose to have a new treatment which uses shock waves.  This new treatment is called, Extracorporeal Shock Wave Therapy (ESWT).   This innovative, non-surgical treatment involves the delivery of sound energy or shock waves to affected areas of the body triggering the body’s own natural repair mechanisms and stimulating healing.  ESWT can be done in the office (low energy) and without the need for anesthetic.

ESWT is a safe and effective treatment option for many kinds of chronic pain associated with tendonitis.  The recovery period is shorter than traditional invasive surgery and the procedure eliminates many of the risks associated with traditional surgery.   Insurance may cover these treatments; however, it would be best to check with your specialist.

For the remaining small percentage of patients who fail to be relieved of the pain, the patient may choose to have surgical correction.  Surgical corrections consist of releasing the part of the plantar fascia from the attachment to the heel bone.  This is done to stop the pull of the fascia on the heel bone, thus stopping the pain.  The physician may also choose to remove the heel spur at this time also. Following surgical correction it will require the patient to be immobilized for a period of time.  The patient will then have the need for rehabilitation later.

In summary heel pain, heel spurs, and plantar fasciitis are common problems that are faced by many patients.  It is a problem that can be controlled and managed without surgery for the majority of the patients suffering from heel pain.

Footcare Express: The Nations First One-Stop Footshop

Jose Menuto, 45, an Argentinian real estate contractor and property manager now living in Miami, injured his left leg six years ago while running a 26-mile marathon. “I tried chiropractors, massage therapists, and everything else I could think of, but whenever I ran or felt stressed, my left leg tightened up.” Because Menuto favored his right leg when he ran or walked, he began having problems in his right knee as well.

Then, Menuto saw an advertisement for Footcare Express, the nation’s first “one-stop footshop.” After a thorough high-tech examination by a podiatrist who diagnosed him with shin splints, an inflammation of the muscles where they attach to the bone, Menuto was fitted for a pair of functional foot orthotics in less thanan hour. “Within two days I was running entirely differently,” Menuto says. “My muscles and ligaments have relaxed in my left leg. I have much more energy, and I now plan to build back up to running 50 miles a week.”

To help athletes, growing children, diabetics, arthritis sufferers and many people with back, leg or hip or knee problems — Footcare Express, a Miami retail store, uses the services of experienced podiatrists to examine a person’s feet, sophisticated video-motion analysis and computerized scanning to identify problem areas, licensed pedorthists to design and fit prescription foot orthotics and modify shoes, and an in-store laboratory to make the devices — all in about an hour.

“Just as the one-hour optical laboratory made it cheaper and much more convenient for people to order eyeglasses, Footcare Express is re-inventing the process of prescribing and making customized foot orthotics,” says Jarett Reinhartz, managing director and co-founder of Footcare Express. “Nobody else in the country has our equipment, our prescription service and our array of athletic and dress shoes, compression hose, support socks, and skin creams and lotions. That’s why we call Footcare Express the nation’s first one-stop footshop.

What’s an Orthotic

Functional foot orthotics are customized rigid or semi- rigid devices inserted into shoes that place the foot in a more functional position and allow it to strike the ground more efficiently, while adding more stability. Foot orthotics relieve pressure points, support the foot more effectively and assure proper alignment of the feet, ankles, knees and legs. In addition to enhancing performance and increasing energy, foot orthotics reduce the risk of injuries.

Footcare Express serves a broad market, ranging from children who need orthotics to correct a gait or walking problem, adults with foot, leg, hip or back pain caused by biomechanical problems or foot disorders, diabetics who need extra foot protection, patients with rheumatoid arthritis, and athletes who put heavy stresses on their feet. A runner, for example, puts as much as three times the normal amount of force from the body’s weight on the feet.

While only a small percentage of the public wears orthotic devices, many more would benefit from wearing them, says Reinhartz. “If you have chronic back pain, knee problems, high arches or flat feet, changing your gait could remedy the pain.”

Don Bailey, Jr., vice president of Don Bailey Carpets in Miami, began wearing orthotics as a professional football player with the Tampa Bay Bucs and the Indianapolis Colts. “When it was time for a new pair, I went to Footcare Express,” says Bailey, who also broadcasts pregame and sideline radio shows for the University of Miami Hurricanes. “They did a wonderful job, with personal treatment and individualized attention. My wife is a marthon runner who was having problems with her heel and hip, and orthotics helped her, too.”

Traditionally, a patient who needed foot orthotics might wait three to six weeks from an initial visit to a physician to receiving the orthotic device, manufactured from a plaster cast at a lab in another city or state. The cost would be $300 to $1,000, plus professional fees.

An hour-long process
In contrast, Footcare Express completes the process in about an hour, using sophisticated laser scanners and CAD-CAM technology to make the prescribed orthotics at a total cost of $200 to $450. “It’s a different mindset than going to a doctor’s office,” says Reinhartz. “Our store has it all.” Footcare Express has won praise from foot care professionals, as well as its clients. “I am very pleased with the foot orthotics they produce,” says James Losito, D.P.M., professor at the School of Podiatric Medicine at Barry University. “They keep physicians involved in their business, and I approve of their techniques. Their prices are very fair and their products have met with excellent patient compliance.”

Reinhartz projects first year sales of $350,000 with a staff of three. “Our Miami store is an excellent prototype for the foot orthotics store of the future,” he says. “We hope to expand this concept and open similar stores in other markets in Florida and the rest of the United States.”

The idea of Footcare Express originated with Jarett Reinhartz’ father — Harold Reinhartz, D.P.M., a podiatrist with 29 years experience who dreamed about opening a store for most footcare needs. In 1996, Harold and Jarett Reinhartz, began creating a business plan and exploring the industry.

After researching different markets, it became clear that South Florida would be the best fit for Footcare Express. “Miami’s demographics were exactly what we were looking for — a large marketplace with sports teams, college students and senior citizens,” says Jarett Reinhartz.

A high-tech approach
One of Footcare Express’ distinguishing characteristics is its high-tech approach to correcting foot problems. After a physical examination of the foot, a computerized gait analysis is performed using the new F-Scan equipment. Paper-thin, disposable sensors placed in a person’s shoes feed information into a computer, which generates a three-dimensional image of the reactive forces between the foot and footwear as they occur. Next, a video motion analysis is used to study the person’s gait while walking or lightly jogging on a treadmill.

Finally, a laser scanner generates a three-dimensional computerized image of the feet showing any pressure points or potential problem areas. That computerized file is transmitted to the store’s own orthotics mill, which manufactures the device, according to specifications from a licensed physician, who dispenses custom-designed orthotics and modifies over-the-counter footwear to meet an individual’s needs.

“I enjoy helping people with diabetes, arthritis and other foot problems, as well as the many athletes, children, teenagers and other adults who can benefit from wearing correctly designed footwear,” says Dr. Reinhartz. “When someone is in pain, it’s important to bring them relief as quickly as possible.”

In addition to custom-made functional foot orthodics, Footcare Express offers high-end athletic and comfort shoes such as Saucony, Asics, New Balance, P.W.Minor and Softspots, as well as other foot- related products. The store itself, at 7756 SW 88th Street, was designed by Sandy Samole, president of the Interior Design Association of Florida.

“It’s an ongoing process to keep your feet healthy and working properly,” says Reinhartz. “We’re here to help keep you going strong.”

Boston Red Sox Sports Orthotics

Mike Reinold
Boston Red Sox
Director of Rehabilitation/
Assistant Athletic Trainer

“I have enjoyed working with Jarett and Footcare Express for all my orthotic needs. They offer an exceptional product, but more importantly stand behind the quality of their orthotics and strive to exceed my expectations.”

Read More Testimonials about Footcare Express Services, Custom Foot Orthotics and Foot Care Products

Sports Orthotics for Boston Celtics

John Hester, DPM
Team Podiatrist for the Boston Celtics

“It is important for me to able to communicate with a custom foot orthotic laboratory that can understand my patient needs and be able to provide the type of devices that can deliver positive clinical outcomes. I have been impressed with Footcare Express’s quality products and excellent customer service”

Read More Testimonials about Footcare Express Services, Custom Foot Orthotics and Foot Care Products

Casual and Dress Foot Orthotics

Walking, working or playing our Casual and Dress custom foot orthotics are the best!

Read more

Footcare Express Annouces New Pedorthist

AVENTURA, FL (January 4, 2008) – Footcare Express, a team of physicians, pedorthists, and biomechanical experts, proudly announces that they have expanded their team of pedorthists with the addition of Vahe Mike Sarkisian to their Aventura, Florida office.

In his role as a Pedorthist, Sarkisian will be seeing patients and filling a variety of physician prescriptions.  Sarkisian will be responsible for measuring, designing, fabricating, fitting and servicing pedorthic devices ordered by a physician.  Sarkisian joined Footcare Express in 2007 as a Lab Supervisor with 11 years of financial business experience and two years of pedorthist experience behind him.

His recent career experience hailed from Pedorthics at Eneslow Foot Comfort center and XL Health Inc. in New York, one of the nation’s largest Diabetic Preventive Care centers, where he fitted and cast patients for shoes and other orthotics, custom footwear and braces as a practicing pedorthist. Sarkisian graduated with a BBA in Finance Investments from Baruch College, Zicklin School of Business, CUNY, New York, NY and became a certified Financial Advisor.  Upon completing Eneslow Pedorthic Institute and the New York College of Podiatric Medicine course, Mr. Sarkisian became a certified Pedorthist in 2005.

Offering a variety of services, including a full service podiatry practice, Footcare Express also includes an extensive retail business and a Pedorthic facility.  The Aventura-based facility is fully accredited by the American Board for Certification in Orthotics, Prosthetics and Pedorthics which ensures that Footcare Express provide the highest standards in fulfilling patient prescriptions for therapeutic footwear and/ or other durable medical equipment including but not limited to foot orthotics, braces and other foot and ankle related modalities.  The physicians and pedorthists at Footcare Express work with various NFL, MLB, NBA and NHL teams and players, including several colleges and universities.

Footcare Express also has its own on-site state-of-the-art Custom Foot Orthotic Laboratory that allows the doctor and technicians to use technology to digitize the foot, allowing for a more accurate replica of the foot, making prescriptions more accurate as well.  Doctors and technicians use the latest technology to diagnose and treat foot problems including the F-Scan, which allows the clinician a split-second perspective on all phases of the walking cycle or gait cycle and through Video Motion Analysis, which captures the gait cycle using fame-by-frame imaging.

Footcare Express opened its Aventura-based office in 2000.  In just 6 short years, Footcare Express has successfully launched a retail portion of its business and increased its availability with various professional sports teams. The company prides itself on offering the most advanced services in the industry.  Footcare Express is a family owned business founded by Dr. Harold Reinhartz and his son Jarett Reinhartz.  Dr. Charles Mutschler is the Medical Director of Footcare Express.  For more information onFootcare Express please call 877.687.3338 or visit www.FootcareXpress.com.

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