My wife and I recently hosted a baby shower for the daughter of dear friends.  In addition to our friends’ daughter, there were three other pregnant women there.  When they found out I was a foot doctor, the questions came flying!  One of the most common complaints during pregnancy is foot pain and swelling of the feet and ankles.  During the nine months of pregnancy, your baby grows and your feet grow along with the baby. It’s very common to see an increase in shoe size from 1/2 to 1 full size. Wearing shoes that fit is the first rule.

Your feet swell due to the weight and position of the baby.  They also swell due to the added weight gain of a normal pregnancy.  All of these things contribute to the ligaments and tendons in the feet stretching.  Many women following delivery will be able to get back into their normal size shoe; however, that’s not the case for all women.  To reduce swelling there are a few things you can do. Wear compression hose, rest, elevate your feet, and massage your feet.

The natural weight gain during pregnancy is the major reason for change in the feet.  Often, your weight gain will cause you to walk differently or compensate by tilting inward, decreasing the height of the arch.  The decrease in arch height can cause arch pain, heel pain, and, most commonly, plantar fasciitis - an inflammatory response to the stress on the ligament holding up your arch.  The good news is that for many women, your feet will return to normal after the delivery, but what to do in the mean time?  A custom device called an orthotics will help hold that arch in its proper position and alleviate the pain you feel.

When pregnant, it is normal for an increase in your blood volume, and some pregnant women will have a mild increase in their blood pressure.  Blood vessels dilate to decrease the flow and pressure, which can lead to a decrease in oxygen to the muscles and often cause foot and leg cramps.  To relive the cramps, it is best to get more blood to the area by simply walking around, and it’s a great way to keep your muscles toned as well.

I wish I had the big secret to keep pregnant women comfortable throughout pregnancy.  All women will experience the ups and downs; however, we can keep your feet comfortable!  Now that your feet and ankles are comfortable, all you need is the answers to the ‘terrible two’s” and the teenage years.

Please feel free to contact Dr. Jeffrey Bowman for more details or any questions by calling 713-467-8886 or at our website: www.houstonfootspecialists.com

Don’t know if you know it or not, but one of Dr. Bowman’s patients, Christi, has been keeping a blog through her experience with Dr. Bowman.  If you haven’t already, you should check it out and read her blog to hear straight from a patient what it’s like to have Dr. Bowman as your podiatrist.  See her testimonial by clicking here.

Christi has need several surgeries to correct the problems in her feet and ankles.  Where many other podiatrists told Christi that she had plantar fasciitis, but only offered injections to take care of the problem.  Dr. Bowman knew that something had to be wrong because of the amount of injections she had received, but the pain still remained.  So he guided her through the surgery process and even preformed the surgery for her. 

But after the surgery for the plantar fasciitis, Christi still had pain in another part of her foot.  After further inspection, Dr. Bowman figured out that Christi’s Anterior Tendon was damaged.  So another round of surgery by Dr. Bowman on Christi’s right foot.  Now she is healing up very nicely and by January, Christi was able to walk a 5k on the beach of Galveston!  Recently, Dr. Bowman also fixed her Achilles Tendon Rupture and she is doing great!

The funniest thing about this though is that Christi is a Ohio State Buckeye, while Dr. Bowman is a Michigan Wolverine.  If you read Christi’s blog, you’ll see the hilarious antics these two have done to support their teams.

If you have any questions on plantar fasciitis, Anterior Tendon damage or any other questions on foot or ankle pain, contact Dr. Bowman at Houston Foot Specialists.  Dr. Bowman would love to help you just like he helped Christi.

And thanks Christi for being such a great patient!  Oh and GO BLUE!!!

Recently I wrote a blog on pre-operative tips before having foot and ankle surgery, and I got many requests to write about what to do after foot surgery.  These are general tips, and different procedures may require more individualized instructions.  Make sure your podiatrist gives you instructions for your specific needs.  Your actions the first 48-72 hours after surgery are critical to your healing and comfort.

Medications:  Take all prescriptions as directed.  Do not use any other medications including aspirin, Tylenol, or Ibuprofen unless you have consulted your podiatrist first.  Most patients will be given pain medication and antibiotics to help prevent infection.  Pain medications may cause constipation and you may want to discuss taking a stool softener with your doctor.  Do not drive or use dangerous equipment while taking pain medication.  Finish all antibiotics given as directed.

Walking:  Depending on what procedure you have, your podiatrist will tell you to stay off your foot for at least 48-72 hours following surgery.  You should limit your walking to just the bathroom during this time.  Some procedures require you to be non-weight bearing on crutches.  This is extremely important and means no weight on the foot at all, sometimes not even resting the foot on the floor while not walking.

Elevation:  The more you keep your foot elevated the less pain and swelling you will have.  If not elevated, you may feel throbbing pain and the bandages may feel tight.  Elevation above the heart is key. While lying down place 2 pillows under the foot; this is usually enough to get the foot above the heart.  It is important to keep your foot or ankle elevated whenever you are not on it. If you can keep it elevated for more than 48-72 hours you should do so.

Post-Op Shoe/Boot:  Always wear the post-op shoe or boot that is dispensed to you whenever you are walking.  Walking without the shoe/boot will cause damage to the surgical site and will cause an increase in pain, and the procedure may not heal correctly.

Keep Bandages Clean and Dry:  The bandages are in place for a purpose and will help to hold the surgical correction in place so it can heal.  If you get the bandages wet, your infection chances increase.  To help keep the bandages dry, get a waterproof cast protector usually available from your podiatrist’s office.  If your podiatrist’s office does not carry them, any medical supply house will have them.  Trash bags with tape do not work, so please do not use them.  The cast protector will fit over your shoe or boot and should be used every time you bathe.  Never remove the bandage without contacting your doctor’s office.

Ice:  Ice should be used for 48-72 hours following your procedure.  If using re-usable ice packs have two so one can be freezing while the other is being used.  Ice should be place on the foot or ankle for 20-30 minutes per hour during waking hours only.  You do not have to use it during the middle of the night.  Some podiatry offices use cold machines which work on their own, and you will be shown how to use it prior to or directly after surgery.  Ice will help reduce pain and swelling.

Blood:  It is normal to notice some blood on the bandage, so do not become alarmed if you see a small amount.  Free-flowing blood is not normal, and you should contact your surgeon’s office immediately.

Feeling Dizzy:  It is normal to feel dizzy or lightheaded the first few days following surgery.  If possible, use assistance when walking.  If you have been lying down, sit up slowly and remain sitting with your feet over the edge of the bed for at least one minute before standing.

Numbness:  The local anesthetic used during the surgery may last up to 48 hours.  This means you may not feel anything or be able to move your toes for this time period.  The numbness may make it hard to feel the effects of not following the directions.  If you have not elevated your foot above your heart, not walked only to the bathroom, not used cold to minimize swelling, or not taken your medication as prescribed, you may have more discomfort than anticipated once the anesthetic has worn off.

Swelling:  You will get a certain amount of swelling following any foot or ankle surgery.  Elevation above the heart will help reduce this.  If the bandage or cast feels too tight, touch the end of your toes to see if they blanch white then pink within a few seconds.  If so, then this is normal.  If it takes longer for the normal color to return or a blue color is noted, call your doctor’s office immediately.

Prevent Blood Clots:  Unless you are in a cast, it is good to move your foot at your ankle for a few minutes each hour.  If you feel severe pain to the back of the leg, knee, or upper leg with redness and heat call your surgeon’s office right away.

Fever:  It is normal to run a low-grade fever for up to 72 hours following surgery.  If the fever persists or exceeds 100 degrees, call your doctor’s office.

Keep all appointments:  It is essential to keep all follow up appointments with your podiatrist to ensure you are healing properly.  Redressing may be performed to your foot or ankle.

These are general tips to follow.  Your foot and ankle surgeon will likely give you his or her own written instructions.  If you have any questions at any time, you should contact your doctor.  As Dr. Bowman always tells his patients, “no question is too stupid to ask.”

Dr. Bowman at Houston Foot Specialists can be reached at www.houstonfootspecialists.com or by calling 713-467-8886

Chronic ankle sprains, also known as ankle instability, are usually due to repetitive accidents or injuries to the ankle joint.   This differs from an acute ankle sprain when only one injury occurs.  I often get asked by my patients, “Why does my ankle give way simply from walking?”  I answer by asking, “How many times have you sprained your ankle and how often does it give out?”  The answers vary, but most often I hear a patient has had a minimum of 3 prior ankle injuries.  Some patients tell me the ankle gives way once a week.

The ankle joint is a complex joint made up of Tibia, Fibula, and Talus bones and numerous ligaments.  Chronic ankle sprains or instability occur when one or more of the ligaments are either ruptured or stretched to the point that the ankle continually subluxes or “turns under”.
When you meet with your foot and ankle specialists, he or she will perform a simple non-painful test called an anterior drawer sign.  If the test is positive, you have damaged the ligament to the point where it no longer can do its job.  An X-ray, diagnostic ultrasound, or MRI may be ordered to confirm the diagnosis.  

The next question we get usually get is, “When can I return to my activities?”  This depends on the severity of the injury to the ligament.  Treatment is RICE : Rest, Ice, Compression and Elevation.  Your podiatrist may strap the joint with tape in a certain position or place you in a brace or walking boot for a period of time.

If the ligament is completely ruptured, it will often need surgical repair..  The good news is if surgery is needed, the ankle will be difficult to injure again. After they heal, most patients will often say, “My ankle feels so much stronger compared to the uninjured ankle.”  

The most important information is how to prevent an ankle injury.  If an injury is due to trauma, like a fall at work or car accident, then there isn’t much you can do to prevent it.  If you are participating in sports or strenuous exercise, then your podiatrist can show you simple strapping techniques or fit you with a brace to wear in your athletic shoe that will help prevent an injury.

If you do injure your ankle, you should always have it checked by a podiatrist the same day it happens if at all possible.  Many times fractures can occur and need immediate treatment.   Most podiatrists have digital X-rays in their office and can get the results in 30 seconds.  Treat any injury to the ankle as a serious issue to help prevent it from becoming a chronic problem.

If you suspect you have chronic instability of the ankle, contact Dr. Bowman’s office at www.houstonfootspecialists.com or call 713-467-8886.

Just as your house has a foundation, feet are your body’s foundation.  Imagine what would happen if your house’s foundation was out of alignment. Doors would stick; walls would crack; etc.  Similarly, your body can react the same way if your feet aren’t correctly doing their job. However, if you take care of your feet properly, you can minimize or eliminate pain in your body related to the architecture of your feet.

One-quarter of all the bones of your body are in your feet.  These bones are the base of support for all your weight-bearing joints.  If the bones in your feet move in a way they are not designed to, your whole body is negatively affected. You will use your muscles incorrectly, causing pain in your ankles, knees, hips, and lower back.

The most common foot imbalance is excessive pronation.  Pronation occurs when the feet roll in or the arch flattens too much, resulting in increased rotation to the ankles, lower legs, knees, thighs, and hips.  This rotation can lead to a number of problems, such as shin splints or knee, hip, and lower back pain.

After performing a comprehensive examination, Dr. Bowman will determine a course of treatment based on your individual needs.  Dr. Bowman may suggest orthotics to stop the pronation, therapy, stretching exercises, or ice.  Following the program designed specifically for you, your body will feel better so you can resume your normal activities and get comfortably back on your feet.