This will be an open conversation from a Thursday through Monday every month with most of your questions being addressed over the weekend when I have more time. You could live where I practice in Houston, Texas or you could live in Florence, Italy. As long as it’s in English we are good to go.

So the ask Dr. Bowman Blog starts today, Thursday, June 19th and ends on Sunday night June 22nd. To make it easier to get a question trough you can tweet me a message on Twitter (@houstonfoot) or on Houston Foot Specialists’ Facebook page.

So let’s have some fun and ask some questions that you think others might want to know as well.

If you need to see Dr. Jeffrey Bowman as a patient just call 713-467-8886, or go to our informative website, where you can make an online appointment by going to www.houstonfootspecialists.com.

She is a writer about to publish her first novel. We discussed the plot and characters and had a very nice chat, until she asked what I did. I told her I was a Physician and Surgeon of the Foot and Ankle, and immediately the shoes came off. Not only hers but the woman next to her and the one across the aisle. I was taken aback on how many of these women had foot problems from hammertoes to bunions, from corns and callous and everything in between. I looked down at all their shoes and you guessed it. They were all wearing pointy toed high heels.

I have nothing against high heels. They make a woman’s legs more shapely, etc. But they were all 4 inches high. One admitted to me she sprained her ankle twice from the stiletto she was wearing and had to have surgery after the second to fix the torn ligament in her ankle. So we talked about bunions and metatarsalgia and other associated problems that can arise from high heels. Those that are very high more than 3 inches place all the weight on the balls of the feet and the pointy one squish together all the toes and forms corns, bone spurs, bunion pain, tailors bunion pain and hammertoes. 

One woman actually placed her foot on my arm rest and said why do my 3rd and 4th toes get cramps, tingling and numbness. Wishing I had a pair of gloves she had what we call a positive Moulder’s Sign which indicates a Neuroma. We discussed treatment options and she asked for my card. Note to self, carry more cards!

Next the flight attendant came over and wanted to know about her feet. Slipped off the shoes wearing dark hose the outline of her foot looked perfect. No bunions, hammertoes, etc. I asked what kind of shoes she wears and she replied 2 inch height maximum with custom orthotics and never has foot pain.

The moral this true story is always have more business cards with you and educate people that it’s not normal to have foot pain. If you have any foot or ankle pain, give Dr. Bowman a call at 713-467-8886 or online appointments and more information is available at www.houstonfootspecialists.com.

These new young men and women all have to begin somewhere even though their degree calls them doctor. I choose to work with them for two main reasons. I had someone “show me the ropes” when I got out of school.  When I went through my surgical training I had a mentor, actually many mentors, show me and guide me to become the surgeon I am today. The other reason, I enjoy it! I love to teach and even to my patients after a surgery consult, many will say “I feel like I just went through Surgery 101!”

Residents do much more than just work in surgery. They go through intense rotations on many subjects from dermatology, orthopedics, plastic surgery, wound healing, emergency medicine, labs working on cadavers, and the list goes on and on. The first year is heavy on these rotations with some surgery. The following years they still do these rotations, but with more surgery mixed in. 

Surgery rotations are difficult on them as they may scrub 6-10 cases a day with the attending surgeons, and then be on call for emergencies. At first they basically assist the attending surgeon by retracting and listening to the attending surgeon with maybe a little of the procedure given to them. As their skills improve in surgery they are able to do a little more of the procedure but only if the attending surgeon feels comfortable. If I don’t feel comfortable then they are there to observe only. 

I know what you’re thinking. These rookies are doing surgery on me??? They start with easy things or easy procedures with someone like me having my hand on theirs to guide them at all times. There is always the attending surgeon there with them to guide them and take over. If the attending physician doesn’t like what they are doing we stop and do it ourselves. The patient is never in danger because the attending surgeon is always there and will take over when needed. The attending surgeon is not allowed to leave the room. The residents are there to learn, that is the main objective.

When a patient asks me, “Dr. Bowman, you are doing my surgery today aren’t you?” The answer is yes, your health and well being is always my main concern. As time progresses and the residents watch more procedures and practice on cadavers (a personal thank you to those of you that decides to donate your bodies to science) they will be incorporated into doing more but always with our guidance. Rest assured if the resident is not prepared to do a case they won’t be touching you. The attending surgeon will always ask for a “game plan” or a step by step way of what they would do before a case, and if it’s not in guideline with my thoughts, they don’t come near you.

These residents are the cream of the crop or we don’t invite them into our programs so rest assured they are capable and prepared for everything. Again, the attending doctor will never put you in any danger, and we do most of the procedures ourselves. However, these men and women are the future of the medical profession and have to learn somewhere, just as you or I did. We provide that education for them. You will see residents in my office, treating patients and working them up to see me because they don’t teach them how to run a practice in school. They are there to watch and learn.

In all my years in practice I have been teaching and working with these residents because I love to and want to give back to my profession. Some doctors prefer not to work with them and that is their choice. But I can honestly tell you that by the time these fine residents finish their programs I would let any of them do surgery on me and in fact I have!

If you have any questions regarding this topic please feel free to contact Dr. Bowman at 713-467-8886 or through his website www.houstonfootspecialists.com. These are Dr. Bowman’s comments and do not represent those of all podiatrists.

©2013 Jeff Bowman., All Rights Reserved

Investigators found the woman in the apartment of the victim in the Parklane Luxury Condos in what in Houston is called the museum district. Another tenant dialed 911 around 4am telling dispatchers someone was being assaulted.

When officers arrived, Ana Lilia Trujillo answered the door to the unit on the 18th floor of the high-rise. That’s where they found the 59 year old males body. According to Houston police the man was stabbed multiple times. The weapon according to investigators was a Stiletto Heeled shoe.

Investigators detained Trujillo and questioned her at the scene. The killer was initially cooperative, but she reportedly stopped talking to police who transported her downtown for further questioning. The victim lived in the condo, but Trujillo did not and was visiting. Their relationship is unknown.

The victims name has not been released. The motive remains unknown as the investigation continues. Trujillo, 44, is being charged with murder.

All this time I thought Stiletto Heeled shoes were bad for your feet causing many injuries and deformities but never would have guessed they could literally kill.

Dr. Jeff Bowman of Houston Foot Specialists can take care of all you foot and ankle problems due to high heeled shoes. Call his office at 713-467-8886 or online appointments are available at www.houstonfootspecialists.com.

©2013 Jeff Bowman., All Rights Reserved

Before You See The Doctor:

• Bring a history from your PCP.
• Bring Insurance card and ID.
• Know what your co-pay will be.
• Make a list of your symptoms and questions.
• Make a list of all medications you are taking.
• Have a list of any drug allergies and previous surgeries.
• Bring any medical records you may have from other doctors including lab reports, X-rays and MRI.
• Check if you need a referral with your insurance company.
• Call our office if you have any special needs.
• Bring any shoes you have had any difficulty with.

During Your Visit:

• Go over your list of questions with the doctor.
• Take notes if you need to.
• Be honest and open to the doctors questions.
• Discuss symptoms and any recent changes.
• Talk about the medications you are taking and what they are for.
• Tell if you are pregnant or trying to get pregnant.
• Let the doctor know if you have been treated for this problem before and by whom.

After Your Appointment:

• Prepare for any tests the doctor orders.
• Ask how and when test results will be made available to you.
• Schedule your next appointment before you leave.
• Call us with any problems.

Dr. Bowman has all his forms available on his website at www.houstonfootspecialists.com and online appointments are available as well. Contact on our website or you can call us at 713-467-8886.

©2013 Jeff Bowman., All Rights Reserved

Many in the Houston, Texas area are very familiar with the 6ft 5in, 290lb Houston Texan defensive tackle. But few across the country are familiar with the newly released (projected June 1st release) "Mega Watt" Nike Free 5.0 shoes. Watt released via Twitter a glimpse of these sweet kicks, which are great for most foot types and uses.

Nike Free are popular minimalist shoes for all types of training and running. It is common to avoid minimalist shoes for long distances, but there is an on going debate for and against minimalism (mainly because of “SHOCK” absorption).

Watt is one of the most popular young, “ELECTRIFYING” NFL stars. The 11th pick in the 2011 draft out of Wisconsin is known for his freakish size, speed and skills. He was the 2012 NFL Defensive Player of the Year and is donating a portion of the proceeds of his shoe sales to his Children's Athletic Foundation.

You don't have to have a size 15 foot to slip into these "Mega Watts", but the price has yet to be released so don't be "SHOCKED" if they rival Lebron James' "King James" record of $315!

For more information on this blog please contact Dr. Jeffrey N. Bowman of Houston Foot Specialists by calling (713) 467-8886 or online appointments from our website www.houstonfootspecialists.com.

©2013 Jeff Bowman., All Rights Reserved

Because her pain was sharp in nature and after reviewing her history she drank alcohol daily “at least 3 drinks a night”. Bingo, I thought. Alcohol consumption can cause Alcoholic Neuropathy and also because it’s a vasodilator it can cause swelling. First had her circulation tested in my office and was normal. Next, we had a Nerve Conduction Study done. It too was normal.

Gail being frustrated finally took my advice to cut all alcohol and wear compression hose daily. Guess what, no swelling and reduced pain after the first week. Even though pain was reduced I probed further into her family history which on the initial visit she denied any history of diabetes in her family. I asked more questions and she told me her foot pain was reduced but she had “dry mouth and constantly having to go to the bathroom”. Are you sure there is no diabetes in your family I asked. She finally admitted that all her siblings were diabetics “but they never had foot pain and swelling like me”. I asked about their alcohol consumption and she said it was low.

I told her I suspected diabetes was the culprit and sent her to the lab for a random blood sugar in her and urine test. Guess what, both results came back high. Then I sent her to my friend who is an Endocrinologist and he ran a fasting blood test on her. Results? You guessed it out of control diabetic with both diabetic neuropathy and alcoholic neuropathy. She was placed on oral medications and started to lose some weight and after a short period of time her finger sticks were near the normal range.

Moral of this story. Always be open and honest with your doctors be it a Podiatrist or other doctor. Gail is now pain free in her feet and no more constant swelling.

If you have diabetes or are concerned with the complications of diabetes, contact Dr. Jeff Bowman of Houston Foot Specialists by calling 713-467-8886 or visit our website for a lot of material on diabetes and online appointments at www.houstonfootspecialists.com.

©2013 Jeff Bowman., All Rights Reserved

Our feet have up to 80 layers of dead skin. No wonder pumice stones can’t make a dent. Baby Foot is a simple product available at Houston Foot Specialists that is all natural and can make those thick callous disappear. Simple to apply as well. Place your feet into booties available in the kit with alpha hydroxyl acid for a simple hour. After a few days to a week the thick calloused skin that you couldn’t get rid of is gone and lasts a couple of months. You will love the way your feet feel and you will walk more comfortable in shoes and not to mention how much better they will look during the summer months in open shoes and sandals.

If you have diabetes, consult with Dr. Bowman before using it. Simple, Quick and inexpensive way to get your feet to feel like a babies again. Not to mention, it’s Dr. Bowman’s wife’s favorite product. It’s great for men’s feet as well without the embarrassment of being seen in a nail salon.

Contact Dr. Bowman at 713-467-8886 to purchase this product and even ship it for a nominal fee or feel free to come by and pick up a kit.

If you have dry cracked skin you are concerned with Dr. Bowman is always available to discuss it with you and explain any underlying conditions you may have. Call 713-467-8886 for more information or visit www.houstonfootspecialists.com for an online appointment.

©2013 Jeff Bowman., All Rights Reserved

Let’s pick up where we left off and look at some more products that can help people with dry, cracked heels:

Urea Based Emollient: Carmol 40 (40% Urea)

Would you be disgusted if I said the ingredient in Carmol 40 is a derivative of urine? Urea is a chemical compound found in the urine. It can also be synthesized artificially.

This medicine is a keratolytic used for treating dry, rough, scaly skin caused by certain conditions (e.g., dermatitis, psoriasis, eczema, cracked skin, calluses). It may also be used for certain other skin or nail conditions as determined by your doctor.

Some medicines or medical conditions may interact with this medicine. INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. DO NOT START OR STOP any medicine without doctor or pharmacist approval. Inform your doctor of any other medical conditions, including if the affected area is broken or severely irritated; allergies; pregnancy; diabetic or breast-feeding. Contact your doctor or pharmacist if you have any questions or concerns about using this medicine.

Use this medicine exactly as directed on the package, unless instructed differently by your doctor. Apply a small amount of medicine to the affected area. Gently rub medicine in until it is evenly distributed. Wash your hands immediately after using this medicine unless your hands are part of the treated area. STORE THIS MEDICINE at room temperature in a tightly-closed container, away from heat and light. IF YOU MISS USING A DOSE OF THIS MEDICINE for 1 or more days, there is no cause for concern. If your doctor recommended that you use it, try to remember your dose every day.

Home remedies:

Bag Balm: This is worthy of it's own blog. The uses began to soothe cows' utters during milking. It has been used on horse’s hooves, quilting bees, hardworking hands or even to polish leather! People swear by this.

Vaseline + saran wrap: This is for when you are in a sticky situation regarding dry, cracked heels. Place a liberal amount of Vaseline to your heels and feet. Quickly wrap in saran or cellophane and place in socks. Do this before going to bed and remove and wash off in the morning. This, like bag balm, acts like a moisturizer. It is definitely an inexpensive option.

So, just say "No" to crack (see below)! Let me know if there are any other secrets to combated dry heels.

For more information on how to combat any skin condition, please contact Dr. Jeffrey N. Bowman at Houston Foot Specialists (713) 467-8886 or see our website for more information and online appointments at www.houstonfootspecialists.com.

It's that time of year again when the snow boots, or as they are called here in Houston, cowboy boots are replaced with open toe shoes, sandals and flip-flops. One of the most common complaints amongst patients in these shoes is dry, cracked heels. Utilizing shoes that leave the foot open to the elements seems to leave the feet dry and eventually cracked.

In some instances it is more than a change in weather or shoes that clause this drying and cracking. Excessively dry skin can be caused from pathologic disorders such as hyperhidrosis. This causes excess sweating of the palms of the hands and soles of the feet. This excessive loss of moisture can lead to dryness. In other cases a mild fungal infection known as tinea pedis can lead to itching dryness that scales across the bottom and sides of the foot. This can sometimes be confused for dry skin. Eczema or atopic dermatitis is a broad range of skin disorders that can lead to red, itchy, dry skin.

In the absence of these or other pathologies such as diabetes, most people complain of dry skin simply because of the natural reaction to changes the skin can undergo during seasonal weather changes. The most common reason for this sudden dryness is open toe shoes, sandals and flip-flops during spring and summer months.

Today's blog is directed at products that can be helpful to those people with dry, cracked heels without any pathologic disorders.

Moisturizers: Foot Miracle

This unique, therapeutic formula contains 60% Ultra Aloe™– the purest, most potent form of whole leaf Aloe Vera gel. Ultra Aloe™ combined with special moisturizers effectively penetrates through layers of skin to speed up cell renewal and repair dry, cracked feet and heels – fast! It eliminates odors, relieves itching and rejuvenates tired, achy feet too. Your feet will look, feel and smell great.



Keratolytics (All-Natural Chemical Peel): Baby Foot

Baby Foot is designed to remove the unsightly, dead skin cells on your feet that build up over time and can contribute to numerous problems associated with the soles of your feet. Dead skin cells accumulate due to pressure and friction from ordinary activities such as standing, exercising, and wearing shoes. In many cases, feet become cracked and painful from the accumulation of dead skin.

In the past, frequent use of foot files and razors were used to "remove" the dead skin on your feet. However, this was a temporary fix because as we now know from recent research, filing generates more friction to the soles of your feet which in turn creates more dead skin. No more filing with the use of our Baby Foot product.

Baby Foot is an unparalleled, total foot care package that provides you with the opportunity to care for and maintain your feet at home. Our scientifically formulated product contains 17 types of natural extracts which exfoliate and moisturize at the same time. The principal ingredient of Baby Foot is fruit acid which is very gentle, when compared with other acids. The fruit acid penetrates into the layers of dead skin cells and breaks down the desmosomes which hold the layers together. By this process, skin is undamaged but peels easily away from the fresh layer beneath. After peeling, your feet are reborn just like a baby’s foot, giving you healthy, beautiful feet.

Baby Foot contains 17 kinds of natural extracts which have a high moisturizing power and astringency, thus the sole becomes smooth after peeling. Baby Foot not only peels the dead skin cells from your feet, it also maintains the grain of the skin and adds moisture to the skin. Baby Foot happens to be my wife’s favorite for her feet.

If you need more information for dry skin on your feet, please contact Dr. Jeffrey N. Bowman at Houston Foot Specialists (713) 467-8886 or see our website for more information and online appointments at www.houstonfootspecialists.com. Make sure to look for “Part 2” of this blog later this week.

©2013 Jeff Bowman., All Rights Reserved

Very few celebrities do I consider worth the public's praise. Most overindulge in lavishness and ruin their god-given talents by destroying their bodies through drugs and riotous living. Although he was far from perfect, Nesta Robert "Bob" Marley is one of the few celebrity figures I admire.

Why am I bringing up Bob Marley? May is skin cancer awareness month and May 11th marks the 32nd anniversary of Marley's death. Marley succumbed to a type of cancer that was first identified underneath one of his toenails.

In 1977 his toenail was identified as having acral lentiginous melanoma, a type of skin cancer that can display in the feet and toes. It was originally thought that the discolored, red toenail was due to a football injury earlier that year. This was refuted and identified to be a skin lesion from an already existing cancer. Marley was encouraged to have his toe amputated to prevent any further spread of the disease. Marley declined such treatment citing religious beliefs. At this point in the legend's life, he was world famous and was traveling all over Europe and the U.S. on tours. One of my favorite songs "Redemption Song" is said to be Marley's coming to terms with the end of his life. Marley's final concert was in Pittsburg, PA in September 1980 before his health deteriorated and he sought cancer treatment in Germany. For 8 months he battled cancer without success. At terms with his mortality, Marley boarded a plane for Jamaica. On May 11th, 1981, while en route to his homeland, Marley's vital signs deteriorated and his plane was forced to land in Miami, Florida. The cancer had spread to his lungs and brain. At 36 years old, the Reggae Rastafarian died. His final words to his son Ziggy were, "Money can't buy life".

The importance of taking care of each and every little health concern is of utmost importance. Even something as lowly as the foot can merit some attention. An amputated toe could've extended the life and legacy of Bob Marley.

For many Podiatry patients today, the risk of amputation remains high. It must be understood that amputation can often avoid further complications, poor quality of life and even death. With modern prosthetic and biomechanic advancements, amputation of digits, feet and limbs doesn't require major lifestyle changes. Many patients can carry on with their everyday life with small and simple changes.

Marley attempted to sing the music OF the people, not for the people. He wanted to be the voice of many. There are many things he represented that I do not agree with, but his unmatched sound, style and stance make him worthy of tribute.

If you are concerned about skin cancer or have dark nails contact Dr. Bowman at 713-467-8886 or for online appointments go to www.houstonfootspecialists.com.

©2013 Jeff Bowman., All Rights Reserved

Knee scopes are one of the most common procedures offered from Orthopedic Surgeons for a multitude of knee complaints. The use of a "scope" or "arthroscopic" surgeries has made an increase in the foot and ankle. Arthroscopic literally means to look inside of a joint. This is done with the use of a very small, lighted tube, roughly the size of a lollipop stick, to look inside of the ankle. This is done through a very small, 5mm stab incision. Another small stab incision allows the entrance of other surgical instrumentation.

Interestingly, from a historical perspective, the lighting to view the joint has grown from reflected sunlight, candles, burning filaments, gas and electric lamps to today's fiber-optic lights. These powerful fiber-optic lights illuminate inside of the joint while fitting inside of the small camera. To view the joint began with the naked eye and then employed lenses and has developed today into high-definition camera lenses. These cameras project the small area onto larger high definition screens. Technology today allows the use of smaller arthroscopic instrumentation with more and more procedures.

Ankle scopes are used today for a variety of ankle issues. Simple entrance into the ankle joint allows diagnosis of ankle pathology. The surgeon can visualize directly what an MRI or X-Ray may possibly miss. Many ankle complaints can be from previous ankle injuries that result in inflammatory or arthritic changes to the ankle joint. These injuries are easy to treat by simply entering the joint and smoothing the ankle joint defects and any excessive soft tissue linings. Any spurring on the bones of the ankle joint can be smoothed as well, while avoiding a large open incision.

Unfortunately, true ankle arthritis cannot be cured by any procedures, scopes or otherwise. Arthritis is an irreversible problem with treatments aimed mainly at symptoms. Steroid injections can help reduce inflammation to the joint, but scopes actually enter and clean up some of the painful tissue associated with arthritis. Eventually, painful arthritic ankles that fail conservative treatment are destined for either ankle joint fusions or total replacements.

Patients are permitted to bear weight immediately after surgery, however some recommend partial weight bearing for the first 2 weeks. Range of motion ankle therapy exercises are encouraged as soon as tolerable. Sutures are to remain in place for 10-14 days.

Ankle arthroscopy has improved by leaps and bounds over the last 50 years and will continue with an increase in surgeon competency and education and with improvements in technology. Ankle arthroscopy can provide a minimally invasive answer to ankle pain and avoid ankle fusion or replacement for chronic ankle arthritis.

For more information on ankle scopes and ankle pain please contact Dr. Jeff Bowman by calling (713) 467-8886 or visit our website for online appointments at www.houstonfootspecialists.com.

©2013 Jeff Bowman., All Rights Reserved

May is skin cancer awareness month. When we think of skin cancer we usually think of the leathery old woman in Florida who spends way too much time baking herself into skin cancer. To help share in skin cancer awareness here is some info on common skin cancers of the feet.

Squamous Cell Carcinoma begins as a small bump or plaque with a common history of cracking and bleeding. The can start similar to a corn or callus. This is the most common form of skin cancer in the feet. Most squamous cell carcinoma is local to the skin but some can spread throughout the body.

Basal Cell Carcinoma is associated with sun-exposed areas of the skin. It appears as pearly white areas of patchiness or raised skin. It can have leakage or crusting. It is generally associated with local skin damage and although rare, can become malignant.

Malignant Melanoma is a type of skin cancer that can become deadly. It appears as a small dark spot resembling the common mole. These lesions can be found on the feet and toenails. Melanoma displays a deeper growth pattern, growing into the blood vessels and lymph system, making it one of the more deadly forms of skin cancers. For this reason it is important to focus on identifying the ABCDs of Melanoma.

ABCDs of Melanoma:

A: Asymmetry

• If it is a perfect circle, it's less likely to be melanoma. Melanoma is usually asymmetric.

B: Borders

• Melanoma usually presents with uneven borders with an unclear differentiation between good skin and the lesion in question

C: Color

• Not one color is good or bad. Black skin lesions are not always malignant, depending on skin tone. Color refers more to the different colors within the lesion. If it is motley in appearance, it has a higher probability of malignancy.

D: Diameter

• 6mm is the standard cut off for malignant vs. benign diameters. Greater than 6mm (or roughly the diameter of a pencil eraser) is more likely malignant.

Podiatrists have a unique skill at identifying skin abnormalities in the feet and lower extremities. They can help identify and diagnose any questionable skin lesions. One manner to differentiate malignant from benign skin lesions is by way of a skin biopsy. A skin biopsy can be as simple as a small punch of the skin encompassing the lesion. This is usually done in office with local anesthetic to numb the area. Either one small stitch or a simple dressing is all that is needed after the biopsy.

By quickly identifying the type of lesion in question, medical or surgical intervention can give the best outcomes for dealing with these skin cancers.

As always, never self-diagnose and always consult with your physician before seeking medical treatment. Dr. Bowman has the training and personal experiences with helping patients diagnoses and treat these issues. Dr. Bowman can be contacted at 713-467-8886 or online for more information or online appointments at www.houstonfootspecialists.com.

©2013 Jeff Bowman., All Rights Reserved

Because we rely on our feet to get around each day, having osteoarthritis in your feet can affect every single aspect of your life—especially your ability to work and support yourself. Immobility, unemployment, and severe pain have all been known to cause additional depression and anxiety.

If you have osteoarthritis in your feet and can no longer work, you may be eligible for financial assistance through the Social Security Disability program. The following information will help you determine whether or not you are eligible for disability benefits and will give you a better understanding of how the application process works.

Osteoarthritis of the Feet and Qualifying Criteria

To initiate the Social Security Disability application process, you will be required to fill out an application online or in person at your local Social Security office.

The Social Security Administration (SSA) provides specific medical criteria for each disabling condition—including osteoarthritis. The SSA uses these criteria to determine whether or not an individual is truly disabled. If your osteoarthritis has caused severe bone or joint deformity it is likely that you will meet the medical qualifications to receive disability benefits.

Simply put, the Social Security Administration will evaluate your initial application to determine whether or not your osteoarthritis keeps you from working.

Necessary Medical Evidence

Along with your initial application paperwork, the Social Security Administration will require that you provide medical evidence to support your claim. Medical evidence may include documentation of the following:

• Your medical history

• Each of your diagnoses

• Your treatment history

• Your past hospitalizations

• Any lab results such as X-rays and CT scans

If your osteoarthritis has caused you to develop other conditions such as anxiety or depression, it is important that you mention this on your application as well. This is important because the SSA will evaluate the combined effects of each of your medical conditions, not just your osteoarthritis.

Other Requirements

In addition to the medical requirements for Social Security Disability benefits, there are additional financial and work-related requirements. You can learn about the different programs and their requirements here: http://www.disability-benefits-help.org/faq/apply-social-security-disability-insurance-or-supplemental-security-income. 

The Services of a Social Security Disability Attorney

Applying for Social Security Disability Benefits can be complicated and overwhelming for new applicants. If you are feeling stressed or unsure about the process, it may be in your best interest to consult with a Social Security Disability attorney. While hiring an attorney isn’t required, it can often be helpful for those who don’t have the time or energy to navigate the Social Security Disability application alone.

Social Security Disability benefits are a necessary life line for those who can no longer work due to osteoarthritis and other foot conditions. They can help relieve the financial burden of specialty medical treatment, assistive technologies, and supportive care. If you are interested in learning more about Social Security Disability visit the Social Security Disability Help page: http://www.disability-benefits-help.org/disabling-conditions/osteoarthritis-and-social-security-disability.

This is a guest blog written by Molly Clarke from Social Security Disability Help.

©2013 Jeff Bowman., All Rights Reserved

On Monday, we started talking about the gait cycle and the stance phase. Make sure to check out part 1 of the biomechanics of gait and read it before reading this blog. Today we’re going to talk about the other side of the gait cycle, the swing phase and some other points involved in gait.

Swing phase (40% of cycle) - The goal of swing phase is to clear the foot and leg from the ground,  swing it forward over the contralateral (other) limb and catch your momentum coming down.

1. Toe off - end of stance phase/begins swing phase.
2. Acceleration - as the other side is going through stance phase, body weight is propulsed forward carrying with it your momentum. The muscles of your hip, thigh, leg and foot are simply using momentum during this point to literally "put one foot in front of the other". Energy is expended during swing and acceleration, but it is less than when propulsing body weight forward. The foot turns outward which shortens the limb making it easier to clear the ground.
3. Deceleration - to prevent momentum from making the body "getting ahead of itself", aforementioned muscles must now slow the limb down to prepare it for heel contact. The lower leg rotates preparing the heel to again be inverted (remember-uneven wear on outside of your heel) for heel strike.
4. Heel strike - start of stance phase/end of swing phase. Heel is inverted (turned out).

Other points to remember about the foot. The foot is divided into a medial (inside) and lateral (outside) column. The medial column is a "flexible adaptor" with more motion and flexibility. The lateral column is a "rigid lever" which allows the aforementioned gait cycle to propulse from lateral to medial and out through the big toe.

Lateral Column                             Medial Column

The medial arch acts like a shock absorber, bowing and flexing when needed. When running on a sandy beach or soft grass, the position and balance receptors in your body will communicate this surface with your noggin. The foot will automatically adapt to the soft, uneven terrain and without intention you will use more of the inside of your foot. Try jogging 6 miles on a beach then see where your feet are most sore.

When I first studied biomechanics I paid more attention to my gait when running. I started to try and adapt; invert more at heel strike, feel the leg turn outward and propulse through my medial column. The best way to run is as natural and comfortable as possible. You can pay a running coach a lot of money to strengthen certain muscles, and use certain form but for the non-elite, amateurs and "fun-runners" out there, just be yourself when you run!  Being a runner I am a firm believer in custom orthotics as they will place your foot in a more neutral position for the close to perfect walk or run.

For more information on running or walking the correct way contact Dr. Jeff Bowman at 713-467-8886 or online for appointments and more information www.houstonfootspecialists.com.

©2013 Jeff Bowman., All Rights Reserved

Many people complain to me about the outside of their shoe being worn excessively. They say they aren't experiencing any exceptional amounts of pain, but they are concerned that something is wrong. They often report that it doesn't wear unevenly anywhere else on the shoe. The truth is, the outside of everyone’s shoe wears faster and if they pay closer attention it probably is worn out differently on different parts of the shoe. That is 100% normal. This will explain for both walking and running why the outside of the shoe wears faster.

Gait (a fancy word for walking) is divided into two major phases with sub-phases. The gait cycle refers to one side of the body's rotation from the time the heel hits the ground, rolls forward, comes off the ground, and then hits again. This is referred to as one gait cycle. The main difference between walking and running gait cycles is the addition of the "float" phase in running. This is when neither right nor left foot is in contact with the ground.

Stance phase (60% of cycle) - This is any time one foot is in contact with the ground. Remember that gait cycle only refers to one limb. While one limb is in one part of the gait cycle, the other limb is in the exact opposite part. When the right foot is in the middle of stance phase, the left foot should roughly be in the middle of swing phase.

1. Heel strike  -this is when one heel (right or left) first contacts the ground. When the heel strikes, it is slightly inverted (turned towards the midline of the body) resulting in more wear on the outside of the heel of the shoe.
2. Midstance - during midstance, the foot continues to invert (turn in) before it quickly starts to evert (turn back out). This shows uneven wear along the outside of the bottom of the shoe.
3. Heel off - the heel starts to lift off of the ground in what should be a neutral position. There is no such thing as the perfect foot so perfectly neutral does not truly exist. This is where custom orthotics can become highly beneficial. Neutral is defined as being in-line with the lower leg.
4. Propulsion - the motion of the foot moves from the outside towards the big toe as the foot continues to evert (turn out). Weight moves across the ball of the foot from the outside in until you propulse yourself from off of your big toe. At this point the heel slightly everts from midline.
5. Toe off - your body weight shifts out over your foot and you enter swing phase as the toe disconnects contact from the ground.

Stay tuned on our website blog for part 2 of Biomechanics of Gait to learn about the Swing Phase (other 40% of the cycle) to be posted Thursday.

For more information on the gait phases and the correct way for walking or running, contact Dr. Jeff Bowman at 713-467-8886 or online for appointments and more information at www.houstonfootspecialists.com.

©2013 Jeff Bowman., All Rights Reserved

One of the first steps to healthy running is wearing supportive running shoes. Neglecting to wear proper footwear can lead to a variety of foot problems that can cause injury and impede performance.

To find the best running shoe, you must first determine your foot type. Are you a pronator or a supinator, or do you have normal feet? Pronators have relatively flat feet, leading to overpronation (gait in which the ankle rolls inward excessively). Supinators have high arches, leading to underpronation (gait in which too much weight is placed on the outside of the feet). And finally, if you have neutral feet, you have a foot that is in-between a flat-foot and high arch.

For assistance in determining your foot type, consult Dr. Jeffrey N. Bowman who is a runner. Dr. Bowman will perform a gait analysis and provide suggestions about the best running shoe for your foot type. Taking the “wet test” is another way to determine your foot type. To take this simple test, wet the bottom of each of foot and stand normally on a paper bag. After a minute, step off and observe the imprint left by your foot.

Neutral Foot        Flat Foot        High Arch

Follow these basic guidelines for successful running shoe shopping:

• Have your feet measured while you’re standing.

• Always try on both shoes and test your running shoes while still in the store.

• Shop for shoes later in the day; feet tend to swell during the day.

• Buy shoes that don’t pinch your toes, either at the tips, or across the toe box.

• Wear or buy the socks you’ll wear when you run.

• If you wear orthotics, bring them. You need to see how the shoe fits with the orthotic inside.

• People who are pronators (low/flat arch) should, choose a supportive shoe designed for stability and motion control. These shoes help to correct for overpronation.

• People who have a normal arch should, choose a shoe with equal amounts of stability and cushioning to help absorb shock.

• People who are supinators (high arch) should, choose a cushioned running shoe with a softer midsole and more flexibility. These features will compensate for the poor shock absorption of a high-arched foot.

Most brands of running shoes have many different components related to structure and performance to accommodate various foot types and running styles.

If you suffer from bunions, finding the right running shoe may be a little tricky, but it can be done. Look for shoes that provide a soft mesh at the sides for more comfort and cushioning, a wide toe box, and a snug heel for stability.

Looking for a pair of running shoes that fit your feet?  Give Dr. Bowman a call at 713-467-8886 or online appointments and more information at www.houstonfootspecialists.com.

©2013 Jeff Bowman., All Rights Reserved

In the foot, osteoarthritis affects any joint in the foot. Symptoms associated with osteoarthritis are tenderness or pain, stiffness in the joint, swelling in the joint and reduced ability to move, walk, or bear weight. Proper diagnosis, early treatment, and pain management are all key factors in preventing joint deformity and disability.

Treatment entails taking medications for arthritis management. These medications include analgesics and NSAIDs (non-steriodal anti-inflammatory drugs and to provide pain relief and reduce inflammation. Analgesic medications are commonly sold over-the-counter as Tylenol or acetaminophen. Acetaminophen is most effective for mild to moderate pain. NSAIDs have anti-inflammatory, painkilling, and fever-reducing properties. Some common NSAIDs include aspirin, ibuprofen (e.g., Motrin and Advil), naproxen, and prescription medications such as Celebrex.

Experts are divided over the role of acetaminophen versus NSAIDs. Both are commonly prescribed for osteoarthritis and both are equally effective for pain relief. Factors to consider when choosing either analgesics or NSAIDs include cost, risks, and personal preference.

Other treatment options include steroid medications, pads or arch supports, inserts that support the ankle and foot, physical therapy, custom orthotics, and surgery.

Here are a few foot care tips to consider for arthritis management:

• Wear shoes that fit properly and feel comfortable

• Wear shoes with more cushioning and rubber soles

• Perform exercises to help keep your feet pain-free, flexible, and strong:
  • Achilles stretch–With your palms flat on a wall, lean against the wall and place one foot forward and one foot back. Lean forward, leaving your heels on the floor. Repeat 3 times, holding for 10 seconds on each side.
  • Toe pull–Place a thick rubber band around the toes of each foot, and then spread your toes. Hold this position for five seconds and repeat 10 more times.
  • Toe curl– Pick up marbles or any small objects with your toes.

Topical pain medications and warm-water with Epsom salts work really well for osteoarthritis as well.

Consult Dr. Jeffrey N. Bowman to determine the best course of treatment for foot and ankle osteoarthritis. Dr. Bowman can be reached by calling 713-467-8886 or online at www.houstonfootspecialists.com.

©2013 Jeff Bowman., All Rights Reserved

The most common cause of shin splints is inflammation of the periostium of the tibia (sheath surrounding the bones). Some other common causes include flat feet (overpronation), a high-arch (underpronation), inadequate footwear, running on hard surfaces, and increasing training too quickly.

Use the following tips to treat and prevent shin splints:

• For immediate pain relief:
  • ice the area to reduce pain and inflammation
  • take over-the-counter anti-inflammatory (e.g., ibuprofen)
  • rest to allow the injury to heal
• Stretch and strengthen the leg muscles

• Wear insoles or orthotics that offer arch support

• Make sure you have the right running shoe for your foot type and for the activity

• Avoid running on hard surfaces

• Shorten your stride

Consult Dr. Jeff Bowman if your pain is really bad. You will get a full diagnosis to find out if there is a stress fracture in the area. Dr. Jeffrey Bowman can be reached at 713-467-8886 or online at www.houstonfootspecialists.com.

©2013 Jeff Bowman., All Rights Reserved