• GARETH BALE, PFA (PROFESSIONAL FOOTBALLERS ASSOCIATION) PLAYER OF THE YEAR... ENDS HIS SEASON WITH RUPTURED ANKLE LIGAMENT.

Wales National Team soccer(football) player, and Club Tottenham Hotspur player rolled his ankle last weekend during a slide tackle on the field.  Not a career-ending injury, but definitely a season-ending one.

Ankle injuries are too common a problem, especially in athletes changing speeds and directions.  The basic mechanism of an ankle injury is a forced twisting/rolling in, or a forced twisting/rolling out of the ankle. 

Before we go on, let's briefly discuss the ankle joint bones and ligaments.  There are 2 bones that make up the ankle joint, the talus bone and the tibia bone.  The talus and the tibia bones come together and are supported by soft tissue structures, AKA joint capsule, on all sides.  This joint capsule holds the ankle joint together and supports the ankle joint movements.  The joint capsule is made up of individual ligaments on the inside and outside of the ankle joint, that contain or support the ankle joint itself.

The joint capsule/ankle ligaments around the ankle joint resist too much motion in the ankle joint, with the goal of protecting the ankle joint against injury.   BUT, sometimes the force is greater than the strength of the ligaments, and the ligaments fail.  How do they fail?  They fail by stretching, tearing, or rupturing off of the bone.  And sometimes, if the force is so great that the ligaments rupture off of the bone, the bones may break!  In as many as 4 different places in the ankle, and occasionally in the foot as well! 

In Bale's circumstance, the forced twisting of his ankle joint was so powerful that the ankle ligaments failed, and ripped off of the bone.  In young athletic individuals as Bale, it is often necessary to reattach the ankle ligament to the bone in the operating room.  Sometimes the ligament is so shredded that surgeons make a new ankle ligament from tendon to replace what was damaged.  When the most destructive type of ankle injury occurs and fractures, surgeons must put the pieces back together with plates, screws, pins, and rods.    Let's hope this isn't the case for Garet Bale.

For more information about ankle injuries, treatments, etc, visit our website at www.podiatristofnaples.com

NEUROPATHY IN MY FEET? WHAT IS THIS, WHY DO I HAVE IT, & WHAT CAN I DO ABOUT IT??

30% of the population suffers from idiopathic neuropathy, which is neuropathy from an unknown cause.  But what IS neuropathy?  Neuropathy is a disorder of the nerves.  Neuropathy presents as symptoms in the hands, more often the feet, such as tingling, numbness, burning, the feeling of bugs crawling on the skin, and in the worst cases, shooting pains.  Although 30% of neuropathy is a from an unknown cause, another 30% is from a Known cause.... DIABETES.  A few other causes are chronic alcoholism, shingles, medications, AIDS, deficiencies in vitamins, cancer drugs, toxins, and certain diseases/disorders.

 Why does my diabetes cause neuropathy?  Patients with diabetes whose glucose/sugar has been out of control for longstanding periods of time develop neuropathy.  Simply put, the disease effects your nerves when you do not take control of your sugar levels.  Usually the symptoms start in the fingers as numbness first.  Eventually the symptoms are felt in the toes and feet.  Neuropathy IS reversible up to a certain point, but irreversible once the glucose has been uncontrolled for too long.  Many diabetic patients complain of no feeling on the bottom of both of their feet!  This is when trouble can occur.... if you can't feel it, you don't know it!  In other words, a diabetic patient with neuropathy (or any patient with neuropathy) may step on something and never realize the skin is broken on the bottom of the foot.  Bacteria may contaminate this opening, leading to an ulceration and infection.  It's at this point that you may hear of diabetic patients with ulcerations, infections, and in the worst cases, amputations!

How is neuropathy treated?   There are many treatments for neuropathy that are dependant on each individual case.  These include vitamin supplements, prescription medications, diet and glucose/sugar control, and various non-invasive therapies.  The most important treatment is PREVENTION, in the case of diabetes.  Although uncontrollable in some cases, neuropathy is preventable and controllable in Diabetes.  Diet and sugar maintenance are paramount in effectively minimizing the effect of neuropathy.  But remember, chronic longterm uncontrolled sugar = irreversible neuropathy.  When this neuropathy is associated with Pain, the problem is magnified.

For more information about neuropathy, visit us as www.podiatristofnaples.com

Ashton Kutcher born with Webbed Toes!!

Celebrity Ashton Kutcher is no stranger to a good sense of humor.  Ashton has publically announced having been born with webbed toes!  He has been so confident and unashamed as to Show the public this deformity on numerous occasions, even on the Oprah Winfrey show!

Ashton was born with a condition called Syndactyly.  Syndactyly is a condition in which two or more digits (fingers OR toes), are fused together.  Instead of functioning individually, they function as one unit because the skin between the digits is fused.  There is no visible separation between the affected digits, and the digits may resemble a “webbed foot” or a “webbed toe.”

Surprisingly, in normal fetal development, all toes and fingers are webbed!  The separation of the digits occurs naturally during development at approximately 16 weeks.  In the case of Mr. Funny himself, Ashton Kutcher, he was born without the enzyme that dissolves the skin between his two toes. 

Syndactyly usually is not a symptomatic condition, rather, a cosmetic concern.  There are surgical options available to reconstruct webbed toes in some cases.  Ironically, there are other cases in which surgeons purposely Syndactylize digits!!

For more information on Syndactyly and/or Syndactylization, visit us at www.podiatristofnaples.com

Halle Berry & Kate Hudson have extra toes!!!!

Celebrities Halle Berry and Kate Hudson were both born with a condition called Polydactyly.  Polydactyly is a deformity in which an individual is born with one or more extra digits of the hands or feet.  This is usually an isolated deformity resulting from a genetic mutation, but can also be found associated with other syndromes.

Polydactyly in the feet presents as an extra toe, most commonly a fully developed extra ‘pinky’ toe.  Although the extra toe may appear to be fully developed, oftentimes the bones of the toe are not, leading to a limp floppy toe that can be quite uncomfortable.  Treatments include paddings, strappings, over-the-counter inserts or custom orthotics, and shoegear modifications.  Surgical treatment is a serious consideration in Polydactyly when the condition is either symptomatic or a cosmetic concern for patients, especially concerned parents of children born with this condition. 

With all of the plastic surgery happening in the celebrity world, it comes as a surprise that the beautiful Halle Berry and Kate Hudson did not have their extra toes surgically corrected!!  It goes to show, not many people are looking at your feet!! 

Contact Dr. Malinoski with any questions or concerns, and/or more information www.podiatristofnaples.com

MY CHILD HAS FLAT FEET ..... TO TREAT OR NOT TO TREAT??

MY CHILD HAS FLAT FEET....TO TREAT OR NOT TO TREAT??

Much controversy exists among medical specialists and parents of children with "flat feet." As there is much debate in the medical literature whether treatment of children with a non-painful, but an obvious and visible flatfoot deformity can prove beneficial.
A normal foot can be described as one having an arch, which is that space between the big toe and the heel on the inside of both feet. This area should be elevated off of the ground while standing, and shaped like a cave or arch. There should be enough space there that you could slide a couple of fingers underneath of your foot, as if your fingers are entering the 'cave.' This gentle curvature of the arch is also visible while the foot is off of the ground/not standing or walking. Those individuals with flatfeet are missing that cave or arch, and this side of the foot touches the ground, sometimes so incredibly flat that the foot actually makes a suction-type sound with every step! In extreme cases, the arch is so collapsed that one may walk on the inside of the ankle!
Depending on the severity of the flatfeet, there are many treatment options. Options include, in specific cases, serial casting (a series of casts applied over time to babies in hopes of correcting the deformity), over-the-counter arch supports or custom orthotics, and surgical reconstruction in the most painful & deformed cases.
A common misunderstanding is that All flatfeet should be treated with arch supports or custom orthotics. This is false. The most import consideration is age of the patient. Many parents present to the pediatrician or podiatric surgeon requesting orthotics for their child's flatfeet. Newsflash! Childrens' feet appear flat until the age of 4 or 6! Prior to, the arch is not fully developed, and often masked by "baby fat.'' It is not uncommon for parents to begin noticing and become concerned about the flattened appearance of the feet during this time. Parents being parents, present their complaint, and oftentimes their children are prescribed orthotics without a flatfoot deformity at all. We end up 'treating the parents,' when orthotics were not necessary to begin with, disrupting the natural growth of the soft tissues and bones in the child's foot, which could prove detrimental in the future.
Next we enter children after age 6, when the arch begins to appear. During this age, usually, either the children are complaining of pain in the arches during and/or after play, OR, parents notice the flattened appearance of the foot. Over the counter inserts or custom orthotics would of course be indicated in the children complaining of pain. And in the most extreme cases, surgery. But what about those without pain, but with obvious flatfeet?? This is where it becomes tricky. An important question to ask is "Does mom or dad, brothers or sisters, grandmother or grandfather have flatfeet? Any were these flatfeet problematic?" Flatfeet are hereditary. If there is a relative with symptomatic flatfeet, then the likelihood of the child developing symptomatic flatfeet is increased. However, that is Not Always the case. There is some medical literature that supports custom orthotics to stop the progression of flatfeet in children. It is certainly worth a try!
Some children have SEVERELY painful flatfoot deformities that require surgical reconstruction for pain-relief. These cases are few and far in between, but do exist in every podiatry practice.
In summary, some of the most famous professional athletes have flatfeet. Some of them are painful, others are not. Some need treatment, others do not. The decision is purely individual in each case. The answer cannot be found in any medical journal, informational blog or reading material. If there is a concern, the child needs to be examined.
To have your child examined for the severity of their flatfeet, email Dr. Malinoski via her website at www.podiatristofnaples.com

GOUT IN MY FOOT/TOE!!!!???

GOUT IN MY BIG TOE....???

Everyone has heard of the term GOUT.  But not many individuals are familiar with what Gout truly is, unless they've experienced gout's agonizing pain personally, or watched a loved-one temporarily suffer the symptoms.

Gout is a disorder of metabolism.  It all starts with something called Purines.  Purines are found in the foods that we eat.  Purine-rich foods include such indulgences like alcohol, particularly beer, meats, seafood, and certain vegetables and legumes.  These purines are naturally broken down via metabolism in the human body, into a product called Uric Acid.  The Uric Acid is excreted through our kidneys. The breakdown of purines into uric acid is a natural process in human metabolism.  BUT, when our body has difficulty excreting the uric acid, That is exactly when gout flare-ups begin.  This excess of uric acid builds up into certain joints of the body, and in the foot, the most common location is in the big toe joint.

Why does the body have difficulty excreting the uric acid??  Most frequently, after ingestion of these protein-rich foods, the body cannot keep up with excreting the extra uric acid, and these uric acid levels build up.  Sometimes, there is a defect in one's metabolism where the individual is missing a certain enzyme that breaks the purines down into uric acid, resulting in excessive uric acid build-up with nowhere to go!

This abundance of uric acid likes to live in certain locations in the human skeleton, like knees, elbows, ears, and in the big toes!  Once settled into their favorite location, the area becomes extremely red, swollen, and painful!  So painful that a common description of pain is "so uncomfortable that a bedsheet touching my toe is excruciating!!"

Again, the initial presentation of gout in the big toe presents as a red, hot, and swollen toe/joint that is significantly painful.  Xrays are usually taken in the office, but it takes approximately 10 years for xrays to show xray signs.  So remember that they xrays probably won't show anything at all, but soft tissue swelling. 

Gout is a diagnosis based on your doctors clinical suspicion.  In other words, we suspect gout when the patient presents with the red, hot, swollen joint,  has a history of gout, has eaten purine-rich foods recently, and sometimes when they've bumped or stubbed the toe.  ( That's right, sometimes trauma can precipitate a gout attack!). 

What treatment should you expect if you present to your foot doctor with gout?  Simply stated.....xrays, possibly a cortisone injection into the joint to break up inflammation and pain, an oral medication specifically prescribed for acute gout, and labwork to review your uric acid levels.   That's it!  Usually, the symptoms are improved in a day or two, and resolved in 5-7 days.  Sometimes patients are prescribed gout medications to take daily for life to protect you from future gout flare-ups. 

What can you do to protect yourself from another painful gout flare-up?  First and foremost...diet control!  Limit those purine-rich foods mentioned above!  Gout is nicknamed "The Rich Man's Disease."  Why??  Because those purine-rich foods like meat and seafood are expensive!  Secondly, take your gout medication daily to prevent a new flare-up.

Although gout has a predilection for certain populations, it can affect anyone.  We are seeing patients with symptomatic gout in surprisingly young ages recently.

For more information about Gout and any other lower extremity question or problem, email Dr. Malinoski via her website at www.podiatristofnaples.com

FOOT INJURIES COMMON AMONG STAND-UP PADDLE BOARDERS (SUP'ERS).

FOOT INJURIES COMMON AMONG STAND-UP PADDLE BOARDERS (SUP'ERS).

Stand-up paddleboarding, AKA SUP'ing, has become a popular leisurely activity as well as competitive event on the Gulf Coast of Florida.  Last May, the First Annual Stand-Up Paddle Championship was held at Madeira Beach.  This year’s event is scheduled in Madeira Beach at the end of this month, check out GCSUPS.com.  SUP’ing has taken off in Florida!

I went SUP’ing for the first time one week ago with an experienced friend, who spent many days SUP’ing amongst the waves of Hawaii.  Not only was this a new experience for me, it was also surprising for my friend!  Being used to riding the rough swirling waves of HI, my buddy was quite surprised, and almost bored! 

Although the Gulf Coast waters are flat, SUP’ing continues to be a workout!  The moment I was able to find my balance on the board, I immediately felt the muscles of my core working and pumping.  Surprisingly, my shoulders and arm exhaustion were secondary to the aching arches of my feet from gripping the board so tightly for the sole purpose of not embarrassing myself with a fall!  After all, we were SUP’ing along the Gulf Coast of beach-goers in April!

Studies show that the most common injuries from SUP’ing are upper musculoskeletal in nature, AKA shoulder, elbow, and arm tendonitis -- from paddling, of course.  No surprise to me, tendonitis of the feet and/or ankles is a close second!  The feet attempt to find the balance on your board, and react abruptly to centralize your body, gravity, and forces to keep your body on the board.  If your core is weak, your feet are the first to respond, and the first to compensate for and pick up the slack of your core balance problems.  Foot and ankle cramping, aching, pain, and tendonitis follow!

For more information on how to properly safeguard your feet and ankles against injuries from Paddleboarding/SUP’ing, email Dr. Malinoski via her website at www.podiatristofnaples.com

It’s not as simple as flipping onto your head when your feet and ankles ache!! My experienced friend ‘SUP’ing’ last week)…

   

 

Another Professional Athlete Ankle Injury...TIM DUNCAN San Antonio Spurs.

Last week, Tim Duncan, Ace player of the San Antonio Spurs,  suffered an ankle injury after landing on the left foot/ankle awkwardly coming down from a jumper.  His absence from play is 'indefinite,' as no one from the NBA is willing to comment on the Truth of his injury and extent of damage.

The public has been made aware that there has been no bone damage and that the MRI was negative for anything specific,  and Duncan was diagnosed with a Grade I or II ankle sprain. 

WHAT IS AN ANKLE SPRAIN??

An ankle sprain is secondary to a forcible turning in , or a forcible turning out of the ankle joint.  There are ligaments (soft tissue structures that attach from one bone to another, to stablilize a joint and keep the joint together) on the inside/medial side, and outside/lateral side of the ankle joint.  When these ankle ligaments are disrupted, usually by a twisting injury, an ankle sprain results. 

There are 3 major type of ankle sprains.

Type 1 -- the ankle joint ligaments are stretched. 

Type 2-- the ankle joint ligaments stretch and tear, much like a a piece of silly putty tears in the middle when stretched too far.

Type 3-- the ankle joint ligaments are stretched so far that they pull off of the bone, and sometimes pull off a piece of bone with them, and can become so damaged that they shred into nothing.

Often times with ankle sprains, other areas of the foot and ankle can become damaged, even fractured!

Moral of the story is, Tim Duncan is on crutches.  The injury could be minor or major.  NBA playoffs could be at stake!

Any questions and/or comments welcomed.

Visit Dr. Malinoski via her website at www.podiatristofnaples.com

Tom Brady Navicular Stress Fracture Foot Surgery.....

NFL superstar quarterback (and hunk) Tom Brady, of the New England Patriots, had foot surgery on January 20th of this year.
Tom had a lingering stress fracture of the navicular bone. 
The WHAT??!?
The navicular bone!
The navicular bone is a "boat-shaped" bone in the foot, also in the hand, and Also in a Horse's foot/hoof!
The navicular bone is one of 26 bones in the human foot, and is, surprisingly, commonly injured in athletes.
The navicular bone is a player in 3-4 joints of the foot, and supports the arch, so you can imagine its role in a professional athlete's foot with every forceful step taken!
Tom had a screw surigcally placed across the body of the navicular bone to stabilize the stress fracture, and to decrease the chance of it propagating across the body of the bone, just as a small crack in your windshield continues to spider across the glass. 
As a fracture grows, it becomes larger and less stable, and the liklihood of the bone displacing or dislocating increases, and major problems can follow.
In Tom's case, he was out of options.  He played with the stress fracture for weeks and months during the season, despite conservative treatments.

It has been 9 weeks since the surgery.....
It generally takes bones approximately 6-8 weeks to heal.
I would bet that Tom has begun a formal physical therapy program and will continue to rehab to strengthen the soft tissues the foot for at least another 3 weeks. 
The public will be hearing an update on Tom's status any day or week now....

Check back Here for Tom's update As Soon As It Is Released!!!!

Do you think the screw will need to be removed?
Place your bets here...  :o)

Visit us at www.podiatristofnaples.com

Did Serena Williams' foot surgery cause her life-threatening clot!?!?!

 Myth Buster #2.   "If I decide to have foot surgery, my risk of developing a life-threatening blood clot increases, just like professional tennis player Serena Williams! "

FALSE!!  And Whoa, whoa, whoa!  There are Many risk factors associated with blood clots!  Not Just foot surgery!  Genetics, birth control, a sedentary lifestyle, smoking, trauma, females of child-bearing age, prolonged durations of sitting (like being on an airplane or a long drive for many hours), again I repeat GENETICS!

Surgery is NOT the only cause of blood clots!  SURGERY IS NOT THE ONLY CAUSE OF BLOOD CLOTS!!

The public only knows what the media tells us.  The public thinks they know that Serena Williams had one or two foot surgeries which caused her to develop a clot in her lung and stomach that required emergent surgery.  Well, is there a History of blood clots in Serena's family?  We don't know.   Does Serena herself has a history of blood clots?  We don't know. Does Serena smoke?  Probably not, but we don't know!  Has Serena been on an extended airplane ride, YES!!  Is Serena of child-bearing age? YES again!!  Yes, Serena had a recent foot surgery, but this does not necessarily tell us that foot surgery caused Serena's clot.   As you can see from above, there is a combination of risk factors that may or may not have predisposed Serena to a clot. 

Unfortunately for Serena Williams and many Americans, blood clots happen.  It is the responsiblity of your medical doctor and surgical specialist to identify the potential risk factors that you as a patient may have, and to decrease the liklihood that you'll develop a clot.

Dr. Kelly Malinoski, DPM works very closely with your primary care physicians to have a complete patient history of medical conditions, medications, allergies, surgical history, and family history.  If we are discussing elective foot/ankle surgery, and there is a high-risk of blood clot, the surgery will not be done.  As with any surgery, there IS ALWAYS the risk of clotting.  There are specific precautions that are taken to significantly decrease this potential risk, i.e, oral drugs to decrease the chance of blood clotting, early physical therapy and range of motion exercises to get your body and your legs in motion, and sometimes cuffs place around the legs that regularly inflate and deflate with air compression to get your blood moving when you yourself cannot!

The moral of the story is, foot surgery is not the sole culprit in one's chance of developing a blood clot.  The most important factor in blood clot development are the risk factors that you individually possess, that IN COMBINATION, can increase your liklihood of developing a clot.  Yes, Serena Willaims had foot surgery, but she also had RISK FACTORS.

Visit Dr. Malinoski at www.podiatristofnaples.com

Is Foot Surgery REALLY as painful as I hear???????

Myth Buster #1.  "I have always been told Never to have foot surgery because it is Incredibly painful, and the recovery is awful....Is this True??"

FALSE!!!  Medicine and surgery have come a long way.  In ancient times, brain surgery and amputations were performed on patients anesthesia-free, and/or with the only products available, such as wine or brandy!  Yes!  Doctors would literally pour wine or brandy on the surgical site for numbing purposes!  As one can imagine, this was not particularly comfortable!  Fortunately, we now live in an age where different types of anesthesia are readily-available to surgeons and specialists to supplement post-operative comfort levels during and after the necessary surgical procedures.

My patients report Minimal to No pain after surgery, and the majority do not need to take the prescribed pain medication.  This includes All types of foot surgeries, from minor elective procedures like bunions and hammertoes, to major procedures such as foot or ankle reconstruction and emergent trauma surgeries.   Why & how, you ask??

  Dr. Kelly Malinoski, DPM answers, "There is a combination of things I do before, during, and after the surgery to minimize patient discomfort.  Just prior to surgery, I give a local anesthetic block around the surgical site, that completely numbs a portion of the foot from 24 to sometimes 48 hours after surgery.  During the surgery, I am very careful in my dissection and in my handling of the tissues.  Afterall, the more delicate I handle the tissues, the less likely they are to respond as feeling "damaged," minimizing a lot of swelling that could ensue.  I prefer to close the skin with sutures/stitches that are absorbed by the body, and do not require uncomfortable removal in the office.  After the procedure, I give the patient an injection of medication that supplements in swelling-reduction and pain-reduction.  Most importantly, I bandage the foot/ankle in such a way that I feel is most comfortable for my patients, and again, aids in swelling and pain reduction.  Finally, my patients are given prescriptions of pain medication and special anti-inflammatory medications post-operatively for a specific time period.  Although the anti-inflammatory medications are required, the pain medications are not, and are usually sitting in the medicine cabinet unopened. "

Elective foot and ankle surgery is not what is once was, folks.  The pain is minimal, specifically controlled, and easily tolerable!

Recovery time is different for each patient, depending on the necessary procedure to correct the problem, and whether or not your situation requires a prolonged period of non-weight bearing, AKA, a cast or boot and crutches.  Dr. Malinoski says, "I've found that as long as the patients' pain levels are controlled, their recovery time is unremarkable.  Surprisingly, not every foot/ankle surgery requires crutches!" 

Visit Dr. Malinoski at www.podiatristofnaples.com

Shockwave Therapy/ESWT For Heel Pain

Shockwave Therapy for my heel pain? What is all the hype about, & can it work for ME??

Shockwave therapy for the treatment of heel pain is a Non-invasive, PAINLESS procedure used to manage that nagging pain you feel that "you've tried everything for," and feel with every step you take!
That's right, no hospital, no operating room, no surgical blades, no bandages, no stitches, no PAIN!!

Shockwave therapy involves resting your heel on a machine that pounds high energy sound waves into your heel through the skin. These 'sound waves' penetrate the soft tissue structures and bone in your heel and break up some of the scar tissue that causes your discomfort. The special products in your body that heal tissue are attracted to the shockwaves, and a healing response occurs over time!

Dr. Kelly Malinoski specialized in this technique during her Fellowship training, and conducted a study following up with patients 9 years after having the procedure. 88% of patients were extremely satisfied after the procedure, 84% of patients had an improvement in heel pain, and ALL patients returned their regular activities in less than 4 weeks!

Heel pain is a common complaint among the patients presenting and treated in podiatrists' offices, particularly in the active population! Many patients, young and old, are competitive and/or leisurely tennis and golf players. These individuals typically complain of pain in the heel(s) most intense with the first few steps taken during the competition that ‘eases up’ as the game goes on. Sometimes the aching pain is felt in the arches, or even in the back of the heel. Eventually, the pain becomes aggravating enough that it is felt with every step attempting to return a serve, or with every long drive down the fairway. When arch supports, custom orthotics, and cortisone injections fail, that is when we introduce shockwave therapy!

So….you’re wondering what the recovery process is after shockwave therapy??
The procedure takes about ½ hour per foot, in the office. Patients walk in, have the procedure, and walk out with a walking boot worn for an unspecified time period at your doctor’s discretion, depending upon the origin of your heel pain (minimum of 24 hours, maximum of 2 weeks). Patients report NO pain during the procedure, and mild tenderness after the procedure for approximately 48-72 hours. You can walk, you can drive, you can go to the grocery store, sunbathe & swim, and go to dinner the evening of the procedure! Again, no hospitals, no operating room, no surgical blades, no bandages, no stitches, NO PAIN!!

How many treatments??
The number of treatments is dependent upon the type of shockwave therapy recommended for you, as well as your personal schedule and flexibility. To sum things up, there are two types of shockwave therapy—High energy and low energy. High energy shockwave therapy requires one treatment, and the sound waves are of a higher frequency level. Low energy is 3 treatments 7-10 days apart and the sound waves are of a lower frequency level. Our patients respond positively to both high and low energy shockwave therapy.

What are the disadvantages?
Unfortunately the majority of insurance companies do not cover the procedure despite shockwave’s impressive beneficial results in the medical literature. Therefore, shockwave therapy is an out-of-pocket expense. The medical community is hopeful that shockwave therapy will be compensable by insurance companies in the near future.

Why should I choose shockwave therapy over a surgical procedure?
Because shockwave therapy has been found to be equally beneficial to an open surgical procedure, without the risks that open surgeries introduce (pronounced pain, swelling, infection, & the need for another surgery/revision).

Visit Dr. Malinoski at www.podiatristofnaples.com