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Medical & Surgical Treatment of Foot & Ankle

Your best choices for your family's foot care needs

Heel Pain=Plantar fasciitis, Well Not Necessarily.

Heel PainDr. Holdren Otis

“You almost want to pee in your bed rather than go to the bathroom. It’s really painful in the morning,” Albert Puljos, a baseball player for the Angels, said it best in an interview with USA today in 2013.  Plantar fasciitis, also known as heel spur syndrome, is the most common cause of heel pain. It is seen in individuals  who are physically active or have increased their daily activity. The plantar fascia itself is a thick band of tissue attaching to the heel bone, the calcaneus. Tugging and pain are usually felt at this attachment, but pain can be in the arch as well. Pain in the morning and when getting up to walk after sitting for a period of time are common complaints.

Although plantar fasciitis is the most common cause of the heel pain, there are other more serious things that can cause pain in the same area. These things include a stress fracture of the calcaneus (heel bone), which occurs with increased activity as well. Also tarsal tunnel, very similar to carpal tunnel of the hand and wrist, can cause shooting pain, tingling and numbness to the foot. In children the closing of the growth plate can cause heel pain when running and jumping. Having your heel pain checked out by a doctor is very important to rule out the other diagnoses. In addition, your pain can be treated quickly and efficiently with all that the medical community has to offer. It is abnormal to have heel pain that does not go away. Call Fenton Footcare today to see one of our doctors.

Good Luck to All Crim Runners!

Stick with what you know!

If you are like me, you have trained for four months (or more!) leading up to the Crim. It is quite difficult to be a runner in the greater Flint area and not consider doing the Crim each year. Flint knows the Crim. People from the area who have never run the Crim know that the longest race is 10 miles and not a “marathon.” I always look forward to seeing Flint in such a positive light. The local bands and cheerleading teams impelling me to run faster always make me smile. I love seeing the people of Flint waking up to come out of their homes around the course and cheer for all the runners.

Post Race 2014

Post Race 2014, Dr. Liz Baker, Dr. Kelly McConnell and Fenton Footcare’s Dr. Holdren Otis

Training for months prior has allowed you to figure out which shirt, shorts, shoes and socks work best for you on long runs. Don’t deviate from what you know for a race. If you have recently purchased a new pair of shoes but have not gotten a long run in them, leave them at home on race day.

If this is your 30th Crim or your 1st, I know it will be a great experience. I look forward to hearing your times and seeing your pictures. Dr. Holdren Otis

SCIENCE: Can I have normal blood work and still have gout? Yes!

Dr. Holdren Otis

Dr. Holdren Otis DPM

Dr. Holdren Otis, DPM

Gout is a type of arthritis that affect joints making them red, hot, swollen and yes, PAINFUL. It occurs mainly in men but it doesn’t leave women completely out. A flare can occur out of nowhere, waking you up at night and even the light touch of the bed sheets can cause you to jump to the ceiling. The most common place to find gout is the in big toe joint but it can show up in the knee, ankle and little toes too.
Gout is an accumulation of uric acid crystals in and around a joint. These crystals can be removed from the joint and seen under a microscope, looking like shards of glass, which makes sense because that is exactly how it feels!
When blood is drawn to determine if you have gout, it measures the concentration of uric acid. It is normal to have some uric acid in your blood because it is a breakdown product of some types of foods that you eat. These foods include steak, seafood, beer and some fruits.
If your blood is drawn during an attack, looking for uric acid, it may register as normal. Why? The majority of uric acid is not in your blood, but is in the form of crystals in your joint! It only makes sense. It is better to draw blood a few weeks after the flare has resolved to see if you need to be on a longer term gout medication. It is important to keep this uric acid in check because gout is a type of arthritis and can cause permanent damage to your joints.
Do you have gout flares? If so, there are treatments in the office that can make you feel better quickly! You don’t have to suffer during a flare. Call Fenton Foot Care for an Appointment (810) 629-3338.

Choosing the Correct Running Shoe

Dr. Holdren Otis

Dr. Holdren Otis

Dr. Holdren Otis

I am a runner, I also get lots of questions from patients about what shoe to buy. Running shoes are the only essential piece of equipment needed for the distance runner. Studies have shown that 35-60% of runners have minor musculoskeletal injuries EACH year. There are multiple reasons for injury including overuse, running surface, poor strength/flexibility, biomechanics and lastly, shoegear.
“Running shoes come in a variety of shapes and sizes, so how do I tell which one is right for me?”
First, here is some background on running shoes. Shoe companies try to help with the decision by categorizing their shoes into Cushioning, Stability, Motion Control, minimalist and “barefoot” types. The idea behind these categories is to reduce injury and give options because feet come in all shapes. Cushioning shoes are designed for runners with a stable foot that needs some shock absorption. Stability shoes are made to have a medium amount of support. Motion control shoes have medial arch fill and lots of cushioning for a more stable ride. Minimalist shoes are made to be lightweight, without arch support and are highly flexible. Barefoot running shoes are made to give a few millimeters between you and the ground to protect your skin. Many research studies have been conducted and it has proven difficult to correlate gait and foot type with the “correct” type of shoe. With 125+ different running shoe companies all doing their own thing-the best way to know is to try a shoe on.
*** please note that I stay away from the common terms “pronation” and “over pronation” when describing shoes and running gait. Pronation is an often misused term and a complex motion because it involved three motions in the foot, dorsiflexion, abduction and eversion. Pronation is not a bad thing that needs to be stopped, it is a normal and essential motion of our running and walking gait.

“What should I look for in a shoe?”
Make sure the shoe fits when you first put it on and walk in it. Shoes will rarely stretch out or form to your foot as you wear them. Some shoes stores will even let you run on their treadmill with your new shoe options. The toebox must have enough room for your toes, both width and depth, so blisters, calluses, toenail problems and pain do not slow down your training. The heel should not slip or rub. If you wear orthotics or inserts bring them to the store with you to make sure you have the perfect fit.
“When should I replace my shoes?”
A study in 2008 showed that running in a pair of shoes for as little as 200 miles can decrease the cushioning and cause adaptations in running gait! The range of running shoe life time has been given between 350-600 miles. I prefer about 350-400 miles. If you notice your ankles, knees or back are a little more achy than usual, consider the age of your shoes. Alternating two pair of good shoes can be helpful as well.

Children’s Shoe Buying Tips

ActiveSoccerSports1One of the most important purchases on any parent’s shopping list should be a pair of proper fitting shoes for their child. The podiatrists and staff of Fenton Foot Care are would like to share several important factors that parents should consider while back to school shopping:

  • Children’s Feet Change with Age. Shoe and sock sizes may change every few months as a child’s feet grow.
  • Shoes That Don’t Fit Properly Can Aggravate the Feet. Always measure the child’s feet before buying shoes, and watch for signs of irritation.
  • Never Hand Down Footwear. Just because a shoe size fits one child comfortably doesn’t mean it will fit another the same way. Also, sharing shoes can spread fungi like athlete’s foot and nail fungus.
  • Examine the Heels. Children may wear through the heels of their shoes quicker than outgrowing shoes themselves. Uneven heel wear can indicate a foot problem that should be checked by a podiatrist.
  • Take Your Child Shoe Shopping. Every shoe fits differently. Letting a child have a say in the shoe buying process promotes healthy foot habits down the road.
  • Always Buy for the Larger Foot. Feet are seldom precisely the same size.
  • Buy Shoes That Do Not Need a “Break-In” Period. Shoes should be comfortable immediately. Also make sure to have your child try on shoes with socks or tights, if that’s how they’ll be worn.
  • Consider Closed Toe Shoes. Covering the child’s toes allows for more protection.

Do Your Child’s Shoes “Make The Grade?”

  • Look For a Stiff Heel. Press on both sides of the heel counter. It shouldn’t collapse.
  • Check Toe Flexibility. The shoe should bend with your child’s toes. It shouldn’t be too stiff or bend too much in the toe box area.
  • Select a Shoe With a Rigid Middle. Does your shoe twist? Your shoe should never twist in the middle
  • Are the shoes secure on the foot? Laces or Velcro are best to hold the foot in place.

If your child is experiencing foot pain or you have other concerns, please make an appointment today by calling: 810.629.3338 [FEET].  Don’t live with foot pain, call today!


Dr. Hirt Named Educator of the Year!

Educator AwardThe staff of Fenton Foot Care would like to congratulate Dr. James Hirt on being honored with the Educator of the Year Award for Podiatry for the Academic year 2014-2015 from Genesys Regional Medical Center Medical Education Department!

When asked about the achievement, Dr. Hirt said “I am very privileged to be able to participate in the education of the next generation of podiatrists. I find it very rewarding to see the progression of the podiatry residents as they advance through their 3 years of office and surgical training, becoming experts in the field.Dr Hirt and award I am very pleased that one of the outstanding graduating residents, Dr. Erin Holdren-Otis will be joining our Fenton Foot Care office. Dr. Holdren-Otis has a level of knowledge and expertise that will be a great addition to our team. I would also like to wish the other graduate, Dr. Eric Kuhlman the best as he ventures into his fellowship in advanced foot and ankle reconstruction.”

Congratulations to both Dr. Hirt and Dr. Holdren-Otis on their achievements; we couldn’t be prouder!

Dr. Holdren-Otis Comments on Miguel Cabrera’s Calf Injury

Miguel CabreraMiguel Cabrera, the Detroit Tigers 1st baseman and big hitter, painfully took off from 1st base during a hit and run in the 4th inning of the July 3rd game against the Toronto Blue Jays. The Tigers went on to win but learned after an MRI that they would lose Cabrera for 6 weeks due to a calf strain.  Reports say that he has a grade 3 strain of the calf muscle, which is the worst of the strains.  It must be a bad injury because this is Cabrera’s first stint on the disabled list in his 12 year career.  He has played with a fractured navicular in his foot, anterior ankle spurs, and a core muscle tear, all of which required surgery in the off season.  Cabrera was batting .350 in 77 games, including 16 doubles, 15 home runs and 54 RBIs.

The calf muscle is comprised of two separate muscles, the gastroc and soleus, that come together to form the largest tendon in the body, the Achilles.  They are the main plantar flexors, aka push off power, for the lower extremities.  Injuries are usually the result of a sudden push off force, an over stretching of the muscle, or changing of direction, and can occur no matter how strong the muscle.  Strains are graded from 1 to 3, three being the most severe.  Grade 1 involves 10% of the muscle belly, and the athlete feels mild discomfort but can still continue playing.  The next day the calf may be tight and sore but usually resolves in 4-5 days.  Grade 2 can involve up to 90% of the muscle fibers and pain is felt when walking or pushing off; some swelling and bruising may also be seen.  These injuries can make the calf very tight and deeper achy pain can be present for 1-2 weeks or more.  Immediately after a Grade 3 tear the athlete feels sharp pain which can involve a partial or full rupture of the muscle.  Swelling and bruising normally occur and it is painful to fire the muscle. Only when the muscle is fully torn is surgery indicated.

Unfortunately, calf strains like Miguel Cabrera’s just take time to heal.  Rest is the most important thing for him at this time.  Already, Cabrera has undergone Platlet Rich Plasma (PRP) therapy, which concentrates his own blood and injects the important healing factors back into the calf.  He has also spent time in the hyperbaric oxygen chamber to help increased the amount of oxygen getting to his calf, increasing his healing potential. Lastly he has a heel lift in the boot he is wearing to make sure the calf muscle doesn’t stretch too much while he walks during his recovery.  The tendon is not involved so no surgery will be needed, but it will take at least 6-8 weeks to heal fully.  Lots of rehabilitation will also be needed to regain the ability to push off his left leg.  Even with all the advanced technology at the fingertips of Tigers’ Athletic Trainer Kevin Rand, it will still take time for Cabrera’s soft tissues to heal.  Rand is hopeful that Cabrera will be back at the 6 week mark.

I myself have also suffered a calf strain in the past and it was very painful! I am hopeful too that Miguel will return quickly, but I am not so sure.  The team will definitely miss him in the meantime. Go Tigers!

Welcome Dr. Holdren-Otis!

IMG_04651We at Fenton Foot Care are excited to welcome Dr. Holdren-Otis!  We made sure her first day was as festive as possible, complete with an unexpectedly balloon filled office!  Dr. Holdren-Otis grew up in Portland, MI and completed her undergraduate studies at Albion College.  During her four years as a Briton, she competed in varsity volleyball as a setter/right blocker and ran sprint relays, 400 meter hurdles and the 3000 meter steeple chase for Albion’s track team.  She also journeyed to Honduras for a medical mission. Dr. Holdren Otis graduated with a Major in Biology and Religious Studies and was a member of the Beta Beta Beta Biological Honor Society.

Dr. Holdren-Otis received her medical education at Scholl College at Rosalind Franklin University in North Chicago, IL.  Throughout her training, she worked at Cook County Hospital as well as at multiple VA venues.  Dr. Holdren-Otis continued her training at Genesys Regional Medical Center in Grand Blanc, MI, where she learned advanced techniques for the treatment of diabetic wounds and received 3 years of surgical training for correction of all foot and ankle deformities. She currently lives in Grand Blanc with her husband. In her free time she enjoys running, baking cookies, her dogs, the Detroit Tigers, and spending time with her nieces.

Dr. Holdren-Otis is excited to be a member of the Fenton Foot Care family, and is ready to help you!  Call 810-629-3338 (FEET) for an appointment today!

How To Protect Your Feet This Summer

Happy_Feet_in_SandNow that the weather is warmer, our feet are much more exposed to the elements.  When we wear sandals, flip flops, or go barefoot, we expose ourselves to many more opportunities for foot problems.  Sandals and flip flops don’t offer much support, and pool areas and public showers can breed infections such as plantars warts and athlete’s foot.  Exposed feet are also prone to sunburn.

Below is some good advice to help you keep your feet healthy this summer:

Going Barefoot

  • Limit your time going barefoot as it exposes the feet to sunburn, infections, and injury due to lack of support.
  • Don’t forget to apply sunscreen to your feet, especially the top and front of your ankle.  Re-apply after going in the water.
  • Keep blood flowing while relaxing in the sun by doing periodic ankle flexes, toe wiggles, and calf stretches.
  • Some summer activities require different type of foot wear, so be prepared and always pack an extra pair of shoes just in case.  If your shoes get wet, make sure to dry them out completely before wearing them again to prevent the growth of fungus and bacteria.
  • If you injure your foot or ankle, make sure to see a podiatrist.  Many people see only a family doctor when something is broken or sprained, but a podiatrist can start treating you and getting you back on your feet immediately.

Flip Flops

  • Do not wear flip flops while running or playing sports, they offer no support and put you at great risk of injury due to lack of heel and arch support.
  • Flip flops should be worn in places bacteria could be such as pools and public showers

Be Prepared

In case of minor foot problems, be prepared with this on the go foot gear:

  • Flip flops to protect your feet at pools, spas, hotel rooms and airport security screenings.
  • Band Aids for minor cuts and scrapes.
  • Antibiotic cream to treat any skin injury.
  • Blister pads or moleskin for blisters.
  • Motrin/Advil to ease your tired and swollen feet.
  • Sunscreen.
  • Aloe vera or Silvadene cream to relieve sunburns.

If you have any questions, visit the patient education section of our website, or make an appointment today.  We offer prompt appointments and no waiting to be seen.  We value your time and want to help you keep your feet happy!