Five Signs Your Child May Have a Foot Problem

Foot and ankle problems in children often go unnoticed. Signs and symptoms can be subtle, and sometimes children can’t explain what’s wrong. But it’s important to protect growing feet and have problems checked out early.

Dr. James M. Cottom, DPM, FACFAS, a member of the American College of Foot and Ankle Surgeons, offers five warning signs parents should watch for.

  1. Your Kids Can’t Keep Up with Their Peers

If children lagbehind in sports or backyard play, it may be because their feet or legs are tired. Fatigue is common when children have flat feet. The muscles in the feet and legs tire easily because the feet are not functioning as well as they should.

  1. Children Voluntarily Withdraw from Activities they Usually Enjoy

If they are reluctant to participate, it may be due to heel pain — a problem often seen in children between the ages of 8 and 14. Repetitive stress from sports may cause muscle strain and inflammation of the growth plate, a weak area at the back of a child’s heel.

  1. They Don’t Want to Show You Their Feet

Children may feel pain or notice a change in the appearance of their feet or nails but don’t tell their parents because they fear a trip to the doctor’s office. Dr. (LAST NAME) encourages parents to make a habit of inspecting their child’s feet starting at a young age. Look for any changes such as calluses, growths, skin discoloration, or redness and swelling around the toenails.

  1. Your Child Often Trips and Falls

Repeated clumsiness may be a sign of in-toeing, balance problems or neuromuscular conditions.

  1. The Child Complains of Pain

It is never normal for a child to have foot pain. Injuries may seem minor, but if pain or swelling last more than a few days, have your child’s foot examined.

If you’ve noticed any of these signs in your children, call Dr. Cottom’s office at 941. 924.8777 or contact us for an assessment.

Meet Our New Doctors

Meet Our New Doctors

Steven Douthett is a native of Michigan and a graduate of Aquinas College, where he received his bachelor’s degree in Biology. Dr. Douthett received his medical degree at Scholl College/Rosalind Franklin University in North Chicago, Illinois. Following medical school, Dr. Douthett completed residency through Beaumont Health System in Wayne, Michigan, where he received comprehensive training in foot and ankle trauma as well as reconstructive surgery. There, Dr. Douthett took a keen interest in medical research, and has completed peer-reviewed studies and presented on various topics including bunion surgery, total ankle replacement, and major limb deformity correction. Dr. Douthett is board qualified in foot, rearfoot and ankle reconstructive surgery.

 

 

Kelly McConnell is originally from Strongsville, Ohio. She completed her undergraduate studies and was recruited to play division one soccer at St. John’s University in New York where she achieved the award of Academic All American. Dr. McConnell graduated with a major in Biology and went on to receive her medical degree at Scholl College/Rosalind Franklin University in North Chicago, Illinois. While in medical school, Dr. McConnell served as president of the Illinois Podiatric Medical Student Association. She went on to complete her residency training in podiatric medicine and surgery at Genesys Regional Medical Center in Grand Blanc, Michigan, where she served as Chief Resident. She is board qualified in foot, rearfoot and ankle reconstructive surgery.

 

Rare Diabetes Foot Complication Becoming More Common In The U.S.

Few people with diabetes know about the limb-threatening foot condition, or its warning signs

As diabetes rates soar nationwide, a Sarasota, FL foot and ankle surgeon says he’s seeing more patients with a rare diabetic foot complication.

The condition is called Charcot foot (pronounced SHAR-co). Foot and ankle surgeon Dr. James M. Cottom, DPM, FACFAS, says it involves a sudden softening of the foot’s bones. This can trigger an avalanche of problems, including joint loss, fractures, collapse of the arch, massive deformity, ulcers, amputation, and even death.

“As the foot’s structure collapses, the bottom of the foot can become convex, bulging like the hull of a ship,” says Cottom. “But diabetes patients frequently won’t feel any pain because they have severe nerve damage in their lower extremities.”

Cottom says every person with diabetes should know the Charcot foot warning signs: a red, hot, swollen foot or ankle. Several other dangerous conditions, such as deep vein thrombosis and acute infections, share these symptoms. A red, hot, swollen foot or ankle requires emergency medical care.

The American College of Foot and Ankle Surgeons (ACFAS) estimates less than one percent of people with diabetes develop Charcot foot. But nationwide, the College’s 6,800 members say they’re noticing more Charcot cases as more Americans develop diabetes.

Charcot cannot be reversed, but its destructive effects can be stopped if the condition is detected early. People with diabetes play a vital role in preventing Charcot foot and its complications. Diabetes patients should keep blood sugar levels under control. This has been shown to reduce the progression of nerve damage in the feet. People with diabetes should also inspect both of their feet every day, and get regular check-ups from Dr. Cottom at Florida Orthopedic Foot & Ankle Center.

For more information on Charcot foot and other diabetic foot conditions, visit the ACFAS consumer Web site, FootHealthFacts.org or contact Dr. Cottom’s office at 941.924.8777 or via the website.

Dr. Cottom is a double board certified in foot and rearfoot/ankle reconstructive surgery.  He has been practicing in the Sarasota and Arcadia, FL area for 10 years.

Foot Pain? You May Have Diabetes

Do you ever feel burning, tingling or numbness in your feet and toes? A Sarasota, FL foot and ankle surgeon warns against ignoring those symptoms. They could be a warning sign of diabetes.

Dr. James M. Cottom, DPM, FACFAS, of Florida Orthopedic Foot & Ankle Center, says those symptoms may be caused by a condition called diabetic peripheral neuropathy, or nerve damage. Neuropathy in the feet can lead to permanent numbness, deformities such as bunions and hammertoes, and dry skin that cracks open and won’t heal.

“Diabetic peripheral neuropathy is not only painful but dangerous,” says Cottom, a Fellow of the American College of Foot and Ankle Surgeons with offices in Sarasota and Arcadia, FL. “It’s a leading contributor to foot ulcers in people with diabetes.”

Burning, tingling and numbness in toes can also be symptoms of thyroid problems, nutritional deficiencies, back problems and pinched nerves in the ankles. In the United States, diabetes is the leading cause of peripheral neuropathy and can lead to further foot complications.

Out of the 23 million Americans with diabetes, one in four has not been diagnosed. Some people learn they have diabetes only after seeing a doctor for burning, tingling and numbness in their toes and feet. Many people already diagnosed with diabetes are not familiar with neuropathy’s symptoms. According to FootHealthFacts.org, even diabetic patients who have excellent blood sugar control can develop diabetic neuropathy.

Medications can treat pain caused by neuropathy. However, nerve damage cannot be reversed.

“When you have diabetes, especially diabetic neuropathy, a minor cut on your foot can turn into a catastrophe,” says Cottom. “The statistics on diabetic ulcers are sobering.”

Twenty percent of diabetes patients who develop ulcers will require an amputation. Patients who are black, Hispanic and Native American are twice as likely as whites to need a diabetes-related amputation. Half of all people with diabetes who have a toe or foot amputation die within three years. The annual cost for diabetic ulcer care in the U.S. is estimated at $5 billion.

For more information on foot problems such as diabetic peripheral neuropathy, contact Dr. Cottom at 941.924.8777 or via the website.

Regenerative Medicine: Evidence Suggests Human Body Best Resource for Healing

The human body may be its own best ally when it comes to the treatment of injuries, ulcers and deformities, especially when it concerns helping a patient’s foot or ankle to heal faster.

“One such advance is using a patient’s own human cells/tissues to help them heal (regenerative medicine),” says Stephen A. Brigido, DPM, FACFAS, a Pennsylvania foot and ankle surgeon and Fellow Member of the American College of Foot and Ankle Surgeons. “An area of continued study among foot and ankle surgeons, using platelet-rich plasma (PRP), shows particular promise for patients needing quick recovery times from a foot injury or surgery,” he added.

During a doctor’s visit, a patient’s own plasma is enriched with their platelets, by taking blood out, almost as if they are donating blood. The blood is then separated. Two healing parts of the blood (platelets and plasma) are injected back into the patient right where they need it most—the injury.

All kinds of patients can benefit from the use of PRP, but some injuries and conditions, or those who are on their feet often, may benefit more from using regenerative medicine techniques.

“Achilles tears, for example, are a common injury for those constantly on their feet,” says Dr. Brigido. “The Achilles can be injected with platelet-rich plasma during a regular office visit and the injection is almost as quick as getting a flu shot. The ‘healing qualities’ of the platelet-rich plasma can turbo-boost healing,” he adds.

Patients living with diabetes are also more prone to ulcers on their feet, wounds that can be very difficult to heal due to poor blood circulation. “The use of PRP treatments can help these patients by bringing healing platelet-rich plasma to a part of the body that is deficient in healthy oxygen-rich blood,” says Dr. Brigido. “The great thing about PRP is it gives patients like this the extra nudge they need to get their own body to start to heal itself,” he added.

Dr. Cottom offers multiple options for patients who are seeking regenerative medicine treatment options.  Please call 941.924.8777 or contact us for more information on this cutting edge office based treatment.

Dr. James M. Cottom DPM, FACFAS announces new office location in Arcadia, FL

Foot and ankle surgeon Dr. James M. Cottom, DPM, FACFAS, today announced the opening of his new additional office locations in Arcadia, FL.  In addition, Dr. Cottom is an active staff member and has privileges at Desoto Memorial Hospital where he routinely operates and is seeing patients.

Dr. Cottom will specialize in surgical and non-surgical treatments of conditions of the foot, ankle and leg including trauma, reconstruction, sports injuries, arthroscopic surgery, total ankle replacement, heel pain and STEM cell injections to mention a few. The new offices are located at 425 Nursing Home Drive Suite 2 and 900 N. Robert Ave 3rd floor Arcadia, FL 34266.  You can contact Dr. Cottom online or call 941.924.8777 schedule an appointment.

“With 12 years of experience as a foot and ankle surgeon, I look forward to providing non-surgical and surgical treatment options for the lower extremity in Arcadia, FL and surrounding communities at our new location,” says Dr. Cottom.

Dr. Cottom is a double board- certified orthopedic foot and ankle fellowship trained foot and ankle surgeon and a Fellow of the American College of Foot and Ankle Surgeons. Most recently, he opened Florida Orthopedic Foot & Ankle Center in Sarasota, FL in January 2016.

Dr. Cottom earned his doctorate in Podiatric Medicine from Chicago Medical School and completed his surgical residency at Detroit Medical Center in Detroit, Michigan.  He then went on and completed a 12-month orthopedic foot and ankle fellowship at the prestigious Orthopedic Foot and Ankle Center in Columbus, Ohio under the direction of Dr. Greg Berlet MD, Tom Lee MD, Terry Philbin DO and Chris Hyer DPM.  This is the same exact fellowship orthopedic surgeons complete if they wish to sub-specialize in orthopedic foot and ankle surgery.  Dr. Cottom is the only surgeon trained this way in the state of Florida.  He treats all conditions of the lower extremity including complex issues that many other surgeons send to him for treatment.

At Florida Orthopedic Foot & Ankle Center we treat all conditions of the lower extremity in a relaxed, slow pace and friendly environment.   We treat our patients as if they are family and take great pride in that.  The training and experience of Dr. Cottom and his team has is what sets him apart from others.

Check Pain Management Off Your List of Foot Surgery Worries

With any surgery comes reasonable concerns. Depending on the person, your mind could start racing anywhere from the seriousness of your condition, to the procedure itself, to out-of-pocket costs or the required downtime. However, when it comes to foot and ankle surgery, there is the inevitable question: How bad will it hurt afterwards?

Even if you have a high tolerance for pain, the unfortunate truth is that pain can accompany the healing process following any surgery. “But, with the proper care, healing after foot and ankle surgery can be more comfortable than people might expect, according to Florida-based foot and ankle surgeon and American College of Foot and Ankle Surgeon Dr. James M. Cottom DPM, FACFAS of Florida Orthopedic Foot & Ankle Center in Sarasota, FL.

“With the availability of such a large variety of highly effective pain medications, fear of pain should be the last deterrent keeping patients from having foot or ankle surgery. Patients can take comfort in knowing that as surgeons, we have an equally vested interest in keeping them comfortable so their surgical experience is positive and they have a speedy recovery,” said Dr. Cottom.

Dr. Cottom explains that patients can receive a local, long-lasting anesthetic immediately before surgery, which significantly decreases pain and can keep the leg numb for 48-72 hours after the surgery.  Most discomfort after any type of orthopedic procedure occurs within the first 24-36 hours after surgery.  With these regional blocks, we are able to keep patients very comfortable after a procedure.. Also, in today’s healthcare climate where efforts to reduce prescription drug addiction are at an all-time high, there are stronger anti-inflammatory medications available, which can eliminate the need for pain relievers containing narcotics.

Of course, not all pain being created equal, there are other options for patients to manage their comfort levels following surgery. Depending on the expected degree of pain, patients can take home a pain pump, which allows them to self-administer pain medication intravenously, allowing for a faster and more potent delivery.

“Ultimately, if a patient needs to undergo surgery, it clearly means something is wrong and requires medical correction or extraction. That in mind, we want to help patients feel good about their surgery and think about how better they will feel afterward, versus the pain during healing,” reasons Dr. Cottom.

Pain Management After Foot Surgery

In addition to medication, a tried and true method in controlling pain following foot or ankle surgery is to apply rest, ice, compression and elevation (RICE). “Using the RICE method reduces swelling in the surgical area. By reducing the swelling, inflammation is minimized, which in large part lowers pain,” added Dr. Cottom.  We will often use a cooling system that is placed inside a patients splint at the time of surgery that works very well at keeping continued cool therapy on the operated extremity.  Many patients have found this to be very helpful in keeping discomfort to a minimum.

The American College of Foot and Ankle Surgeons recommends patients talk to their foot and ankle surgeon before their procedure to determine how much pain they can expect and the plan of action for managing their pain after surgery.

For more information on controlling your pain after foot or ankle surgery, contact Dr. Cottom at 941.924.8777 to obtain more information.

Ankle Replacement Transforms Hopeless Situations into Active Lives

Technological advances in ankle replacement are ushering in a new world of pain-free movement for people suffering from debilitating ankle arthritis. While once severely restricted in their activity, those who undergo ankle replacement can enjoy a complete turnaround and actively participate in life again.

According to the American College of Foot and Ankle Surgeons (ACFAS), innovative design and instrumentation, ankle replacement surgery—also called ankle arthroplasty—have vastly improved over the past decade or so, making it a fast-growing, highly successful solution today for those unable to walk without great pain.

“With contemporary arthroplasty, ankle arthritis sufferers who thought their situation was hopeless can get a new lease on life,” says James M. Cottom, DPM, FACFAS, a Fellow Member of the American College of Foot and Ankle Surgeons and surgeon at Florida Orthopedic Foot & Ankle Center in Sarasota and Arcadia, FL. “For years, they were told they’d always be in pain, but ankle replacement has totally changed their lives—they can now walk with ease, stop going to the pain clinic and stop taking powerful opioid medications.”

Ankle replacement surgery involves replacing a damaged joint with an implant (prosthesis) that serves as an artificial joint. The procedure, which is becoming the treatment of choice, provides important advantages over the historically standard technique of fusing the ankle joint.

“Although fusion eliminates pain and treats the arthritis, it often leaves the patient with a stiff leg and difficulty walking,” says Dr. Cottom. “Fusion also increases the likelihood of developing arthritis in the adjacent joints due to ankle immobility.”

In contrast, ankle replacement surgery gets rid of the pain while also maintaining full range of motion. “It lets you walk with a normal gait and perform activities you couldn’t do comfortably with a fusion. It also takes stress off the joints below and in front of the ankle, decreasing the risk of arthritis developing there.”

Ankle arthroplasty is usually performed on people in their 40s through 80s, younger than typically seen with knee and hip replacements. Ankle arthritis is almost always caused by a previous injury. Often, the injury was sustained as a teenager or young adult, and arthritis developed later.

One case at Dr. Cottom’s practice is a 53-year-old woman who was unable to walk without severe pain due to a fusion performed 20 years ago after a car accident. “Her goal was to walk on the beach, and arthroplasty allowed her to do just that,” said Dr. Cottom. “We took her fusion apart and put in an implant, thus treating her arthritis in that lower joint and giving her a return of motion in the ankle.”

The procedure is performed by making an incision in front of the ankle, removing the arthritic bone and cartilage and inserting the implant. A state-of-the-art instrumentation guides the surgeon in making precise cuts in the bone. “More precise cuts mean tighter, anatomically fitting implants, so they’re less likely to be loosened or misaligned,” explains Dr. Cottom. Today’s implant—a significant improvement over older designs—usually consists of two metal components and a plastic spacer that fits between those metal components.

During part of the recovery period, patients use crutches, a walker or some other mobility aid to avoid putting weight on the ankle, generally between two to six weeks. It typically takes eight to 10 weeks before the patient can wear a regular shoe.

After several years, the plastic lining of the implant may wear out, but that can often be replaced without revising the metal components. “In general, as long as the metal components are intact, the polyethylene can be replaced through a surgical procedure that requires substantially less recovery time,” says Dr. Cottom. Usually after about two weeks, the patient can wear a regular shoe and begin physical therapy.

Although complications can occur with ankle arthroplasty, they are generally well managed by a surgeon experienced in ankle replacement. In selecting a surgeon, Dr. Cottom advises, “Look for a board-certified surgeon who is familiar with ankle reconstruction in general. Ankle arthroplasty often requires other reconstructive work, so the surgeon must be competent in other areas.”  Dr. Cottom is trained on all 8 FDA approved ankle implants and has performed hundreds of total ankle replacements.  He also teaches other surgeons how to implant ankles on a monthly basis.

Not everyone is a candidate for ankle replacement. For example, people with poor blood flow (peripheralarterial disease), loss of sensation (neuropathy) or significant uncorrectable deformity should not undergo this procedure.

“Given the advances in this procedure and its life-altering benefits, ankle replacement surgery is certainly here to stay,” says Dr, Cottom. Clearly, ankle arthroplasty is greatly improving lives and enabling previously pain-ridden people to easily walk, hike, take the kids to the park or just stroll on the beach without pain, discomfort or the need for opioid drugs.

Surgical Procedure Can Correct Crossover Toe, Keep Seniors Active

Crossover toe is a common foot problem that can inhibit physical activity for older Americans, but outpatient surgery can correct the deformity and keep senior citizens active and on their feet.

Individuals with hammertoes, bunions or a second toe that extends beyond the big toe are most susceptible to developing crossover toe as they age, according to Dr. James M. Cottom DPM, FACFAS, a member of the American College of Foot and Ankle Surgeons and founder of Florida Orthopedic Foot & Ankle Center.

“It’s a common problem among older people in which the second toe gradually moves across the big toe,” he says. “It can be painful and, therefore, difficult to walk comfortably or pursue an active lifestyle.”

Cottom says the first symptom of crossover toe is pain in the ball of the foot. A tear in the joint makes the second toe unstable. It falls out of alignment and eventually drifts.

Doctors normally check the ball of the foot for a possible plantar-plate tear when an older patient complains of pain in the area.  Dr. Cottom says pre-existing forefoot problems combined with normal wear and tear or possible trauma can cause the plate to tear over time.

“If the pain persists and the toe starts to drift, surgery may be recommended to suture the plantar plate or replace it through a tendon-transfer,” he says.

Surgery to correct crossover toe is an outpatient procedure performed with a local anesthesia. Patients with bunions or hammertoes are advised to have those deformities corrected during the surgery. Recovery time varies but, most patients are able to walk on their operated foot the next day.

“If you’re an older adult with persistent pain in the ball of your foot, it’s in your best interest to see a doctor,” says Cottom. “If your foot hurts, you aren’t exercising, and your cardiovascular health nosedives.”

Contact Dr. Cottom’s office at 941-924-877 for more information on foot pain, or visit our contact page.

 

 

Going Barefoot? Beware!

Tips for a safer barefoot season in Florida

Parents and families can prevent cuts, puncture wounds and other injuries from going barefoot by following some simple recommendations from one Sarasota, FL foot and ankle surgeon.

“Shoes are the best way to protect your family’s feet from injuries,” says Dr. James M. Cottom, DPM,  FACFAS of Florida Orthopedic Foot & Ankle Center. “But if your summer just wouldn’t be the same without kicking off your shoes or sandals, you can still make it a safe season.”

Dr. Cottom has offices in Sarasota and Arcadia, FL.  He offers these tips for a safer barefoot season

See a foot and ankle surgeon within 24 hours for a puncture wound.

Why: These injuries can embed unsterile foreign objects deep inside the foot. A puncture wound must be cleaned properly and monitored throughout the healing process. This will help to avoid complications, such as tissue and bone infections or damage to tendons and muscles in the foot. Foot and ankle surgeons are trained to properly care for these injuries.

Make sure you’ve been vaccinated against tetanus. Experts recommend teens and adults get a booster shot every 10 years.

Why: Cuts and puncture wounds from sharp objects can lead to infections and illnesses such as tetanus.

Apply sunscreen to the tops and bottoms of your feet.

Why: Feet get sunburn too. According to FootHealthFacts.org, rare but deadly skin cancers can develop on the feet.

Inspect your feet and your children’s feet on a routine basis for skin problems such as warts, calluses, ingrown toenails and suspicious moles, spots or freckles.

Why: The earlier a skin condition is detected, the easier it is for your foot and ankle surgeon to treat it.

Wear flip-flops or sandals around swimming pools, locker rooms and beaches.

Why: To avoid cuts and abrasions from rough anti-slip surfaces and sharp objects hidden beneath sandy beaches, and to prevent contact with bacteria and viruses that can cause athlete’s foot, plantar warts, and other problems.

Use common sense.

Why: Every year, people lose toes while mowing the lawn barefoot. Others suffer serious burns from accidentally stepping on stray campfire coals or fireworks. Murky rivers, the ocean, lakes and ponds can conceal sharp objects underwater. People with diabetes should never go barefoot, even indoors, because their nervous system may not “feel” an injury and their circulatory system will struggle to heal breaks in the skin.

Cottom is a member of the American College of Foot and Ankle Surgeons (ACFAS). He is double board certified in trauma and reconstructive surgery of the foot, ankle and leg.  With offices in Sarasota and Arcadia, he has been in practice in the area for 10 years.  Dr. Cottom can be contacted at 941-685-8817 or visit our contact page to book an appointment.